Organization
SHANNON K WALISER LICSW MPA LLC DBA MIND BODY WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANNON KRISTI WALISER MSW, MPA, LICSW (OWNER)
(304) 363-4265
Entity
Organization
Contact information
Practice address
295 HIGH ST STE 3, MORGANTOWN, WV 26505-5449
(304) 363-4265
(304) 999-4826
Mailing address
PO BOX 1286, MORGANTOWN, WV 26507-1286
(304) 363-4265
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
DP00942521
WV
Other
Enumeration date
04/24/2009
Last updated
07/22/2020
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