Individual
SHANTIL STANSBURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2640 INDUSTRY WAY, LYNWOOD, CA 90262-4284
(310) 627-4525
Mailing address
2640 INDUSTRY WAY, LYNWOOD, CA 90262-4284
(310) 627-4525
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
16020
CA
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
10/25/2017
Last updated
01/09/2025
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