Individual
STEPHANIE SHOCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3535 LAWRENCEVILLE HWY, TUCKER, GA 30084-5805
(404) 764-8499
Mailing address
3535 LAWRENCEVILLE HWY APT D4, TUCKER, GA 30084-5230
(404) 764-8499
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT008898
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT008898
GEORGIA BOARD OF MASSAGE THERAPY
GA
Enumeration date
07/20/2021
Last updated
05/23/2022
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