Individual
SHANNON LEN DEETS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
18278 TECHNOLOGY DR, MEADVILLE, PA 16335-8380
(814) 807-0487
(888) 538-2885
Mailing address
18278 TECHNOLOGY DR, MEADVILLE, PA 16335-8380
(814) 807-0487
(888) 538-2885
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PC004908
PA
103T00000X
Psychologist
Primary
PS018703
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024531890002
—
PA
Enumeration date
08/18/2008
Last updated
05/20/2022
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