Individual
SHALONDRA SUTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-4097
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-4097
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9294
TN
1041C0700X
Clinical Social Worker
C010104
NC
Other
Enumeration date
06/10/2016
Last updated
09/10/2024
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