Doctor Name: | MRS. SHANNON ALISON HARTMAN-WILSON |
NPI Number: | 1447294061 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, LMFT, LPC, NCC |
License Number: | 4390 |
Business Practice Address: | 126 South Main Street Suite 2b Davidson, NC - 28036 |
Business Phone Number: | 7046552827 |
Business Fax Number: | |
Mailing Address: | Po Box 1963, DAVIDSON |
State: | NC |
Postal Code: | 280361963 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4390 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |