| NPI | 1003221318 |
|---|---|
| Former Name | SHANNELL LUCAS-MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 11087) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 20858) |
| 101YP2500X Counselor, Professional (Licence: NC 11087) | |
| 225C00000X Rehabilitation Counselor (Licence: 00118288) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2022-03-01 |