| NPI | 1477700367 |
|---|---|
| Former Name | SHANNON M CORNWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: HI MHC 281) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: HI MAT9172) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2025-07-30 |