| NPI | 1821562190 |
|---|---|
| Former Name | SHAWNTAY THERESA FENYO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 21683) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC10414) |
| 101YP2500X Counselor, Professional (Licence: VA 0701014697) | |
| Enumeration Date | 2019-01-19 |
| Last Update Date | 2025-12-11 |