Individual
SHANNON GOLLNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
201 PHILLIPS CT, OWENSBORO, KY 42303-3772
(270) 683-6481
(270) 926-0817
Mailing address
1760 MARYANNE RD, SHOW LOW, AZ 85901-7420
16183080310
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
252640
KY
251S00000X
Community/Behavioral Health Agency
1005
AK
Other
Enumeration date
05/24/2017
Last updated
03/17/2018
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