Individual
SHAWN SHANNON-MISSAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT-P
Contact information
Practice address
1169 PITTSFORD VICTOR RD STE 250, PITTSFORD, NY 14534-3809
(585) 314-2978
Mailing address
112 NETTLECREEK RD, FAIRPORT, NY 14450-3056
(585) 314-2978
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
P129987
NY
Other
Enumeration date
11/19/2015
Last updated
08/08/2024
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