Individual
CEISHA SHADOR PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6040 WINSTON TRACE, MCDONOUGH, GA 30252
(612) 559-8873
Mailing address
6040 WINSTON TRCE, MCDONOUGH, GA 30252-6896
(678) 559-8873
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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