| NPI | 1821477548 |
|---|---|
| Former Name | SHANNON SCHALLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P1701214) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 4665) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2021-07-23 |