Individual
SHANNON MARIE PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CRC. LPCA
Contact information
Practice address
3410 HEALY DR STE 203, WINSTON SALEM, NC 27103-1568
(336) 774-0006
(336) 774-0007
Mailing address
3410 HEALY DR STE 203, WINSTON SALEM, NC 27103-1568
(336) 207-6139
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A10731
NC
Other
Enumeration date
09/15/2015
Last updated
10/25/2015
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