Individual
TAKENYA SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
199 S HERLONG AVE, ROCK HILL, SC 29732-1186
(803) 233-6394
Mailing address
552 EARL CAUTHEN RD, HEATH SPRINGS, SC 29058-9234
(803) 577-9044
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/31/2018
Last updated
12/31/2018
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