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General NPI Number Information
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NPI Number | 1659043826
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Entity Type | Individual
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Provider Name | SHANNON EN AI CHIEN
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Gender | Female
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 120 E OGDEN AVE STE 220
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City | HINSDALE
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State | IL
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Zip | 60521-3546
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Country | US
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Telephone | 408-614-6264
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Fax |
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Provider Business Mailing Address
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Address Line | 211 E OHIO ST APT 2023
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City | CHICAGO
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State | IL
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Zip | 60611-3253
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Country | US
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Telephone | 408-614-6264
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT116597
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 11897194-3904
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License Number State | UT
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