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General NPI Number Information
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NPI Number | 1013486364
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Entity Type | Individual
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Provider Name | SHANNON MICHELLE TERRELL MS, EDS, ALC, CCTP
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Gender | Female
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Dates
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Enumeration Date | 11/15/2018
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Last Update Date | 11/15/2018
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Provider Practice Location Address
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Address Line | 931 NOBLE ST STE 309
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City | ANNISTON
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State | AL
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Zip | 36201-5667
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Country | US
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Telephone | 256-343-5881
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 MAXANNA DR
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City | ANNISTON
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State | AL
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Zip | 36206-1148
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Country | US
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Telephone | 256-343-5881
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C2952A
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License Number State | AL
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