Individual
SHANNON KELLEY FRASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1799 CLAIRMONT RD, DECATUR, GA 30033-4005
(404) 491-7751
Mailing address
833 CINDERELLA CT, DECATUR, GA 30033-5811
(630) 740-4034
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/22/2021
Last updated
02/22/2021
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