Individual
TAKESHA MONIQUE SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
700 ENERGY CENTER BLVD, SUITE 407, NORTHPORT, AL 35473-5827
(205) 764-0850
(205) 331-4082
Mailing address
700 ENERGY CENTER BLVD, SUITE 407, NORTHPORT, AL 35473-5827
(205) 764-0850
(205) 331-4082
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2536
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-99846
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
Enumeration date
08/31/2007
Last updated
09/15/2009
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