Individual
SHANNON MCKENZIE PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
73 BAY STATE RD APT BF, BOSTON, MA 02215-1812
(603) 562-6735
Mailing address
73 BAY STATE RD APT BF, BOSTON, MA 02215-1812
(603) 562-6735
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
11466
MA
Other
Enumeration date
05/25/2022
Last updated
05/25/2022
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