Individual
SHALLYN SHARIN BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1341 CANTON RD STE B, MARIETTA, GA 30066-6056
(678) 642-2970
Mailing address
75 WASHINGTON ST UNIT 614, FAIRBURN, GA 30213-3605
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW006585
GA
1041C0700X
Clinical Social Worker
Primary
CSW007835
GA
Other
Enumeration date
06/02/2016
Last updated
06/06/2022
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