Individual
KATHERINE SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3292 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 365-8920
(616) 365-8971
Mailing address
3292 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 365-8920
(616) 365-8971
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301017825
MI
Other
Enumeration date
02/10/2020
Last updated
02/10/2020
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