Individual
SHANNON NICOLE HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
214 MAIN ST, BAXTER, TN 38544-5280
(931) 248-0610
Mailing address
214 MAIN STREET, BAXTER, TN 38544-5280
(931) 248-0610
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6944
TN
Other
Enumeration date
05/24/2024
Last updated
05/24/2024
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