Provider Demographics
NPI:1720462302
Name:SHANER, AARON (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:SHANER
Suffix:
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30722-0367
Mailing Address - Country:US
Mailing Address - Phone:706-264-1920
Mailing Address - Fax:706-243-6392
Practice Address - Street 1:111 ELLA LN
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3851
Practice Address - Country:US
Practice Address - Phone:706-264-1920
Practice Address - Fax:706-243-6392
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT001584106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist