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General NPI Number Information
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NPI Number | 1053479808
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Entity Type | Individual
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Provider Name | SHANNON PRINCE NELMES LPC
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 454 S ANDERSON RD BOX 583
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City | ROCK HILL
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State | SC
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Zip | 29730-3392
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Country | US
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Telephone | 803-517-7363
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Fax | 803-366-2037
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Provider Business Mailing Address
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Address Line | 454 S ANDERSON RD BOX 583
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City | ROCK HILL
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State | SC
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Zip | 29730-3392
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Country | US
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Telephone | 803-517-7363
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Fax | 803-366-2037
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4052
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License Number State | SC
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