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General NPI Number Information
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NPI Number | 1831740323
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Entity Type | Individual
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Provider Name | SHANON BRINER
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Gender | Female
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Dates
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Enumeration Date | 09/25/2019
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Last Update Date | 09/25/2019
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Provider Practice Location Address
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Address Line | 701 PAPWORTH AVE STE 209
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City | METAIRIE
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State | LA
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Zip | 70005-4923
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Country | US
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Telephone | 504-236-8775
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Fax |
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Provider Business Mailing Address
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Address Line | 401 WILLOWDALE BLVD
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City | LULING
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State | LA
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Zip | 70070-3053
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Country | US
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Telephone | 504-236-8775
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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 | LA
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