NPI Profile for SHANNON JEAN in RAHWAY, NJ.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Dance Therapist |
225600000X |
| NPI # | 1164034401 |
|
| Status | Active | |
| Credentials | LPC (Licensed Professional Counselor) | |
| Entity | Individual | |
| Enumeration date | 08/18/2020 | |
| Last updated | 08/18/2020 - About 6 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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SHANNON JEAN
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