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Organization

RICHARD E. SHOOK, PH.D., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD SHOOK PH.D., P.C. (LICENSED PSYCHOLOGIST)
(770) 514-0111
Entity
Organization

Contact information

Practice address
127 CHERRY STREET, MARIETTA, GA 30060
(770) 514-0111
Mailing address
127 CHERRY STREET, MARIETTA, GA 30060

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY1908
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00577607A
GA
Enumeration date
05/04/2007
Last updated
08/22/2020
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