Individual
SHANNON WALDRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
404 S WHITE ST, ATHENS, TN 37303-4732
(423) 746-0163
Mailing address
404 S WHITE ST, ATHENS, TN 37303-4732
(423) 746-0163
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8492
TN
Other
Enumeration date
03/19/2018
Last updated
03/19/2018
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