Individual
MR. SHANNON EMMANUEL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYCHOTHERAPIST
Contact information
Practice address
4001 W CAPITOL DR, MILWAUKEE, WI 53216-2530
(414) 455-3879
(866) 719-3024
Mailing address
4001 W CAPITOL DR, MILWAUKEE, WI 53216-2530
(414) 455-3879
(866) 719-3024
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
130697-121
WI
Other
Enumeration date
03/10/2020
Last updated
03/10/2020
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