Individual
LAURYN CHRISTINE SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
14706
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14706
DEPARTMENT OF REGULATORY AGENCY
CO
01
—
LAC-16453
ARIZONA BOARD OF BEHAVIORAL HEALTH
AZ
Enumeration date
06/11/2019
Last updated
06/11/2019
Update your record
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