Individual
CAROLINE SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4555 LAKE FOREST DR STE 650, BLUE ASH, OH 45242-3789
(859) 279-2124
Mailing address
802 WILLARD ST # 2, COVINGTON, KY 41011-1361
(239) 826-8104
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C.2406255
OH
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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