Individual
MS. LATOYA SHUNTEA MCCOLLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
118 UNION ST, CLARKSVILLE, TN 37040-5115
(931) 647-8257
(931) 647-8257
Mailing address
118 UNION ST, CLARKSVILLE, TN 37040-5115
(931) 647-8257
(931) 647-8257
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/23/2009
Last updated
11/23/2009
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