Provider Demographics
NPI:1700452083
Name:MCKEE, SHANNON (EDS, LSSP)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:MCKEE
Suffix:
Gender:F
Credentials:EDS, LSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4306 LASKER BROOK CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1427
Mailing Address - Country:US
Mailing Address - Phone:817-714-7094
Mailing Address - Fax:
Practice Address - Street 1:4306 LASKER BROOK CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1427
Practice Address - Country:US
Practice Address - Phone:817-714-7094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool