Provider Demographics
NPI:1679837439
Name:KLEE, SHANNON NOEL (CD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:NOEL
Last Name:KLEE
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6932 HOVINGHAM CT
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2544
Mailing Address - Country:US
Mailing Address - Phone:703-266-2168
Mailing Address - Fax:
Practice Address - Street 1:6932 HOVINGHAM CT
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-2544
Practice Address - Country:US
Practice Address - Phone:703-266-2168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist