| NPI | 1811085954 |
|---|---|
| Former Name | SHANNON STAR SHEEHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39001654A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401019668) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2021-09-02 |