| NPI | 1528597382 |
|---|---|
| Former Name | SHANNON KATHLEEN STEVENSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2018-03-17 |