| NPI | 1184568123 |
|---|---|
| Former Name | SHANNON CAVANAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WI 18294-33) |
| Enumeration Date | 2026-04-20 |
| Last Update Date | 2026-04-20 |