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Individual

MRS. SHANNON LEANN BANUELOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MAED COUNSELING

Contact information

Practice address
8045 E PORTOBELLO AVE, MESA, AZ 85212-1690
(480) 507-1404
Mailing address
140 S GILBERT RD, GILBERT, AZ 85296-1016
(480) 497-3300

Taxonomy

Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary

Other

Enumeration date
02/21/2007
Last updated
07/08/2007
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