Individual
DR. SHANNON NOEL COSENTINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
805 S CASCADE AVE, COLORADO SPRINGS, CO 80903-4101
(719) 473-9200
(719) 473-9203
Mailing address
16132 OLD FOREST PT, UNIT 307, MONUMENT, CO 80132-8678
(847) 630-5594
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103TC0700X
Clinical Psychologist
0004379
CO
Other
Enumeration date
09/02/2012
Last updated
06/03/2020
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