Individual
DR. SHANNON RENARD WILKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EDD
Contact information
Practice address
6311 STRICKLAND ST, DOUGLASVILLE, GA 30134-1261
(678) 838-8333
(678) 838-8444
Mailing address
6311 STRICKLAND ST, DOUGLASVILLE, GA 30134-1261
(678) 838-8333
(678) 838-8444
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC009455
GA
101YM0800X
Mental Health Counselor
Primary
LPC009455
GA
Other
Enumeration date
11/17/2015
Last updated
12/30/2023
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