Individual
MS. VIRGINIA LEIGH SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC-C
Contact information
Practice address
119 MCKEEN ST, BRUNSWICK, ME 04011-2909
(207) 380-1736
Mailing address
119 MCKEEN ST, BRUNSWICK, ME 04011-2909
(207) 380-1736
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
XL4068
ME
Other
Enumeration date
01/01/2015
Last updated
01/01/2015
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