Individual
SHANNON RENEE BIRKHOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLP, LPC, CAADC
Contact information
Practice address
418 W KALAMAZOO AVE, KALAMAZOO, MI 49007-3334
(269) 373-6000
Mailing address
418 W KALAMAZOO AVE, KALAMAZOO, MI 49007-3334
(269) 373-6000
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301013953
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
774349006
—
MI
Enumeration date
03/18/2009
Last updated
10/25/2019
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