Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1174026413 |
---|---|
Provider Name | Shannon Moris |
First Address | Salt Lake City, UT 84115-5218 |
Second Address | Salt Lake City, UT 84115-5218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2018 |
Last Update Date | 13/03/2018 |