Individual
MRS. CARLY BLAKE SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4144 N CENTRAL EXPY STE 850, DALLAS, TX 75204-3226
(512) 956-6463
(866) 653-5142
Mailing address
5109 HOLY SPRINGS RD, DENTON, TX 76207-4237
(512) 897-2709
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
62456
TX
Other
Enumeration date
11/20/2008
Last updated
09/18/2025
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