Individual
SHANNON MARIE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3715 N 104TH AVE, OMAHA, NE 68134-3790
(402) 953-8400
Mailing address
3715 N 104TH AVE, OMAHA, NE 68134-3790
(402) 953-8400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11386
NE
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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