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Individual

MRS. KELLIE NICOLE SHOUN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
LAMONT ST & VETERANS WAY, JOHNSON CITY, TN 37604
(423) 926-1171
(423) 979-3481
Mailing address
35 PINE HILL RD, MAHWAH, NJ 07430-1012
(347) 439-8414

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
05/10/2016
Last updated
01/30/2023
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