Individual
DR. SHANNON K. DUNLAP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
610 RIDLEY AVE, LAGRANGE, GA 30240-2236
(706) 884-5050
(706) 884-5056
Mailing address
610 RIDLEY AVE, LAGRANGE, GA 30240-2236
(706) 884-5050
(706) 884-5056
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
202201
GA
101YP2500X
Professional Counselor
LPC004718
GA
103TC0700X
Clinical Psychologist
Primary
PSY003497
GA
Other
Enumeration date
05/26/2009
Last updated
02/03/2016
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