| NPI | 1649852930 |
|---|---|
| Former Name | SHANNON CLARK-SIENKIEWICZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO 2021045663) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: UT 12016019-2501) |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2024-08-29 |