Individual
MRS. SHANNON SMITH MOELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCA
Contact information
Practice address
105 S HAMILTON ST, GEORGETOWN, KY 40324-1607
(502) 642-8046
Mailing address
228 QUAIL RUN DR, GEORGETOWN, KY 40324-1330
(804) 517-9640
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
279690
KY
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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