Individual
MS. SHELLEY TASHINA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
304 ARLINGTON DR, VIDALIA, GA 30474-8935
(912) 850-6526
Mailing address
304 ARLINGTON DR, VIDALIA, GA 30474-8935
(912) 850-6526
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC009464
GA
Other
Enumeration date
02/27/2017
Last updated
02/27/2017
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