Shannon Colestock
Counselor, Mental Health in Berlin, NJ. Individual provider (NPI-1).
NPI number1255596243
StatusActive
Last updated in NPPESJul 19, 2008
Details
- NPI
- 1255596243
- Entity type
- Individual (NPI-1)
- Name
- Shannon Colestock
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 19, 2008
- Last updated
- Jul 19, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
128 Cross Keys RdBerlin, NJ 08009-9201
Phone 856-210-1511
Mailing address
128 Cross Keys RdBerlin, NJ 08009-9201
Phone 856-210-1511
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