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General NPI Number Information
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NPI Number | 1205080157
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Entity Type | Individual
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Provider Name | SHANNA L. BECKETT M.A.
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Gender | Female
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Dates
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Enumeration Date | 11/05/2008
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Last Update Date | 11/05/2008
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Provider Practice Location Address
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Address Line | 4221 EAST MAIN STREET
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City | MORGANTOWN
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State | PA
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Zip | 19543
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Country | US
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Telephone | 610-858-5539
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 67
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City | GOODVILLE
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State | PA
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Zip | 17528-0067
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Country | US
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Telephone | 610-858-5539
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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