NPI | 1851436976 |
---|---|
Former Name | SHANNON LEIGH STUART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3655) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA LPCC1154) |
103TC0700X Psychologist, Clinical (Licence: CA 34386) | |
106H00000X Marriage & Family Therapist (Licence: CA MFC 46239) | |
Enumeration Date | 2007-02-20 |
Last Update Date | 2024-08-28 |