Individual
MR. COLTON SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC-MHSP
Contact information
Practice address
708 N HIGHLAND AVE, JACKSON, TN 38301-4829
(731) 277-7778
Mailing address
708 N HIGHLAND AVE, JACKSON, TN 38301-4829
(731) 277-7778
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4374
TN
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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