Individual
CRAIG O SHANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
36745 AIKEN RD, BAYFIELD, WI 54814-4579
(715) 779-3707
(715) 779-3362
Mailing address
618 E BAYFIELD ST, WASHBURN, WI 54891-4408
(715) 779-3707
(715) 799-3362
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5425-125
WI
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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