Individual
ANTHONY SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
302 E HOME PL, AUSTIN, TX 78753-5139
(512) 789-7621
Mailing address
302 E HOME PL, AUSTIN, TX 78753-5139
(512) 789-7621
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
78503
TX
Other
Enumeration date
02/07/2020
Last updated
02/07/2020
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