Individual
SHADONNA ROSHAWN BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADAC 1
Contact information
Practice address
119 RACINE ST STE 105, MEMPHIS, TN 38111-2729
(470) 991-4088
Mailing address
100 OAK VALLEY DR, COLDWATER, MS 38618-6021
(470) 991-4088
(901) 443-5089
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1619
TN
Other
Enumeration date
10/26/2019
Last updated
11/19/2025
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