Individual
SHANNON STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
0001449
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001449
OHIO MENTAL HEALTH AND ADDICTION SERVICES (OMHAS)
OH
Enumeration date
09/25/2019
Last updated
08/31/2021
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