Individual
SHANTA ELIZABETH WARD PANNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA., QMHP-C
Contact information
Practice address
1555 MEADOWVIEW DR STE 5-6, DANVILLE, VA 24541-7351
(877) 848-9810
Mailing address
5721 LEVEL RUN RD, LONG ISLAND, VA 24569-2237
(434) 421-9304
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0733003038
VA
Other
Enumeration date
04/17/2025
Last updated
04/17/2025
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