Individual
SHANON K DETIENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 ARTHUR ST, KNOXVILLE, TN 37921-6405
(865) 637-9711
Mailing address
201 W SPRINGDALE AVE, KNOXVILLE, TN 37917-5158
(865) 637-9711
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
06/11/2008
Last updated
01/30/2019
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