Individual
SHANNON LEE SOUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
8300 CONSTITUTION AVE NE, ALBUQUERQUE, NM 87110-7613
(505) 291-2000
Mailing address
8300 CONSTITUTION AVE NE, ALBUQUERQUE, NM 87110-7613
(505) 291-2000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0002151
CO
101YM0800X
Mental Health Counselor
Primary
0160441
NM
Other
Enumeration date
01/23/2014
Last updated
01/23/2014
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