Individual
SHANNON NANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
4921 PARKVIEW PLACE, MAILSTOP 90-35-703, SAINT LOUIS, MO 63117
(314) 747-5060
(314) 362-1904
Mailing address
4921 PARKVIEW PLACE, MAILSTOP 90-35-703, SAINT LOUIS, MO 63117
(314) 747-5060
(314) 362-1904
Taxonomy
Speciality
Code
Description
License number
State
103TH0004X
Health Psychologist
Primary
2008030851
MO
Other
Enumeration date
02/09/2010
Last updated
02/09/2010
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