MISS Shoshana L Puckett

NPI #1609171941 in Olney, Illinois

Provider Information

NPI Number: 1609171941
Entity Type: Individual
Name: MISS Shoshana L Puckett
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Enumeration Date: Jan 18, 2011
Last Updated: Jan 18, 2011

Practice Location

Address: 504 MICAH DR
Address 2: DRAWER M
City: Olney
State: Illinois
ZIP Code: 62450-4720
Phone: (618) 395-4306

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary
Counselor - Mental Health — Mental Health	101YM0800X

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