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General NPI Number Information
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NPI Number | 1750626420
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Entity Type | Individual
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Provider Name | SHANNON ANN GAISER LPC, NCC, CAC
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Gender | Female
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 20399 ROUTE 19 BRANDT DR, ONE LANDMARK NORTH
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City | CRANBERRY TWP
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State | PA
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Zip | 16066-6134
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Country | US
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Telephone | 724-816-0373
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Fax |
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Provider Business Mailing Address
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Address Line | 555 FALLECKER RD
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City | BUTLER
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State | PA
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Zip | 16002-0027
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Country | US
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Telephone | 724-256-6829
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC004686
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License Number State | PA
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