Doctor Name: | SHANNON SHERMAN |
NPI Number: | 1134315013 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MFT TRAINEE |
License Number: | |
Business Practice Address: | 6765 Green Valley Rd Placerville, CA - 956678984 |
Business Phone Number: | 5306225551 |
Business Fax Number: | |
Mailing Address: | 6765 Green Valley Rd, PLACERVILLE |
State: | CA |
Postal Code: | 956678984 |
Phone Number: | 5306225551 |
Fax Number: | |
NPI Enumeration Date: | 09/24/2007 |
NPI Last Update Date: | 09/24/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |