Individual
SHANNON NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
7486 DREXEL DR, UNIVERSITY CITY, MO 63130-2206
(636) 236-4537
Mailing address
7486 DREXEL DR, UNIVERSITY CITY, MO 63130-2206
(636) 236-4537
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2015014118
MO
101YM0800X
Mental Health Counselor
Primary
2015014118
MO
Other
Enumeration date
11/25/2020
Last updated
11/25/2020
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