Individual provider · Type 1 NPI

Shannon Marie Wiseman

Mental Health Counselor · Santa Rosa, CA

NPI number 1164696597 Active

Practice location

3164 Condo Ct
Santa Rosa, CA 95403-2557

Fax (707) 360-1540

Mailing address

341 Irwin Ln
Santa Rosa, CA 95401-5603

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1164696597

Shannon Marie Wiseman's National Provider Identifier is 1164696597, issued on Apr 16, 2008. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Santa Rosa, CA. The record was last updated on Sep 1, 2009.