Individual provider · NPI-1

Shawn Shannon-Missal, LCAT-P

Art Therapist · Pittsford, NY

NPI number1396119871
StatusActive
Last updated in NPPESAug 8, 2024

Details

NPI
1396119871
Entity type
Individual (NPI-1)
Name
Shawn Shannon-Missal
Credential
LCAT-P
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 19, 2015
Certification date
Aug 8, 2024
Last updated
Aug 8, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
221700000X Art TherapistP129987NYYes

Practice location

1169 Pittsford Victor Rd Ste 250
Pittsford, NY 14534-3809

Phone 585-314-2978

Mailing address

112 Nettlecreek Rd
Fairport, NY 14450-3056

Phone 585-314-2978

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