Individual
SHANNON TERRELL GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
79 KYNDALL LN, FORSYTH, GA 31029-8747
(478) 954-6802
Mailing address
79 KYNDALL LN, FORSYTH, GA 31029-8747
(478) 954-6802
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW001459
GA
Other
Enumeration date
09/01/2006
Last updated
05/15/2024
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