Individual
MS. SHANNON NICHOLE MATHISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LLP,CAADC, IMH-E
Contact information
Practice address
2140 E ELLSWORTH RD, ANN ARBOR, MI 48108-2552
(734) 544-3050
(734) 222-3225
Mailing address
555 TOWNER ST, YPSILANTI, MI 48198-5723
(734) 544-3050
(734) 544-6732
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
6361007153
MI
Other
Enumeration date
04/30/2009
Last updated
04/05/2023
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