Individual
KRIS ELLEN SHOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APC
Contact information
Practice address
4255 WADE GREEN RD NW STE 414, KENNESAW, GA 30144-1763
(678) 213-2194
Mailing address
59 GADDIS RD NW, CARTERSVILLE, GA 30120-4673
(678) 480-4275
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC007485
GA
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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