Individual
MARK S. SHIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSPE
Contact information
Practice address
515 TREMONT ST, CHATTANOOGA, TN 37405-4152
(423) 267-2134
(423) 267-2146
Mailing address
515 TREMONT ST, CHATTANOOGA, TN 37405-4152
(423) 267-2134
(423) 267-2146
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PE1594
TN
Other
Enumeration date
01/26/2007
Last updated
06/30/2015
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