| Shante Pllc | |
|
5995 Oren Ave N Ste 209 Stillwater MN 55082-6777 | |
| (612) 524-9237 | |
| (612) 314-8317 |
| Full Name | Shante Pllc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 5995 Oren Ave N Ste 209, Stillwater, Minnesota |
| Authorized Official Name and Position | Shante Sookhlall Hanson (OWNER) |
| Authorized Official Contact | 6125249237 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shante Pllc 5995 Oren Ave N Ste 209 Stillwater MN 55082-6777 Ph: (612) 524-9237 | Shante Pllc 5995 Oren Ave N Ste 209 Stillwater MN 55082-6777 Ph: (612) 524-9237 |
| NPI Number | 1518781095 |
|---|---|
| Provider Enumeration Date | 11/12/2024 |
| Last Update Date | 11/12/2024 |
| Certification Date | 11/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518781095 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
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