Individual
SHANNON EDMISTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
5820 YORK RD, T300, BALTIMORE, MD 21212-3610
(410) 989-3899
(410) 777-8742
Mailing address
5820 YORK RD, T300, BALTIMORE, MD 21212-3610
(410) 989-3899
(410) 777-8742
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC5373
MD
Other
Enumeration date
05/20/2014
Last updated
05/20/2014
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