Provider Demographics
NPI:1932616893
Name:WOHLMAN, SHANNON (MA, LMFT, LSW)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:
Last Name:WOHLMAN
Suffix:
Gender:F
Credentials:MA, LMFT, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13116 PINE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-3862
Mailing Address - Country:US
Mailing Address - Phone:218-340-4896
Mailing Address - Fax:
Practice Address - Street 1:101 W BURNSVILLE PKWY STE 207
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-0010
Practice Address - Country:US
Practice Address - Phone:952-686-6966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-01
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist