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1609070572
SHANNON GREEN
COSTA MESA, CA
NPI
1609070572
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA MFC47323)
Enumeration Date
2007-06-13
Last Update Date
2009-08-14
Business Address
-- SHANNON GREEN MFT
1055 EL CAMINO DR F-100
COSTA MESA, CA 92626-5574
Phone number: 714-280-6967
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Mailing Address
-- SHANNON GREEN MFT
1055 EL CAMINO DR F-100
COSTA MESA, CA 92626-5574
Phone number: 714-280-6967
Copy
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