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General NPI Number Information
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NPI Number | 1407478704
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Entity Type | Organization
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Legal Business Name | SHANNON MONNIG NELSON, MS, LMFT, CCLS, PLLC
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Dates
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Enumeration Date | 05/11/2020
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Last Update Date | 05/19/2020
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Provider Practice Location Address
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Address Line | 6322 SOVEREIGN ST STE 263
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City | SAN ANTONIO
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State | TX
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Zip | 78229-5188
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Country | US
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Telephone | 210-317-2515
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Fax |
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Provider Business Mailing Address
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Address Line | 6322 SOVEREIGN ST STE 263
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City | SAN ANTONIO
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State | TX
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Zip | 78229-5188
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Country | US
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Telephone | 210-317-2515
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Fax |
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Authorized Official
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Title or Position | LICENSED MARRIAGE & FAMILY THERAPIS
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Name | SHANNON KAE NELSON
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Credential | MS, LMFT, CCLS, PLLC
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Telephone | 210-317-2515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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