| NPI | 1699721936 |
|---|---|
| Former Name | SHANNON RADDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 003783-1) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2022-03-07 |