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Individual

GIANNA R SHOCKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PLPC

Contact information

Practice address
4650 MEXICO RD, SAINT PETERS, MO 63376-1607
(314) 403-0464
Mailing address
3816 SULLIVAN AVE, SAINT LOUIS, MO 63107-2001
(314) 484-6174

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2023042149
MO

Other

Enumeration date
10/30/2023
Last updated
10/30/2023
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