Individual
SHANNON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
1129 TROTWOOD AVE STE 24, COLUMBIA, TN 38401-3046
(931) 334-1136
Mailing address
1101 MANOR RD, COLUMBIA, TN 38401-5139
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1529273
—
TN
Enumeration date
08/14/2007
Last updated
03/04/2014
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