Individual
SHAWNA MICHELLE PANKONIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
12932 SARACENNIA RD, MOSS POINT, MS 39562-7708
(228) 297-4420
Mailing address
12932 SARACENNIA RD, MOSS POINT, MS 39562-7708
(228) 297-4420
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1841
MS
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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