Individual provider · Type 1 NPI

Shannon Bruckbauer

Mental Health Counselor · South Lake Tahoe, CA

NPI number 1972295947 Active

Practice location

1900 Lake Tahoe Blvd
South Lake Tahoe, CA 96150-6305

Call (530) 573-7970 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X9065 (CA)

Mental Health Counselor: Definition to come...

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About NPI 1972295947

Shannon Bruckbauer's National Provider Identifier is 1972295947, issued on May 25, 2023. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in South Lake Tahoe, CA. The record was last updated on May 25, 2023.