Individual
SHANNON BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1504 SPRING HILL AVE, MOBILE, AL 36604-3207
(251) 235-2056
Mailing address
1504 SPRING HILL AVE, MOBILE, AL 36604-3207
(251) 235-2056
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3488G
AL
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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