Individual
ANTUAN SHORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 S ZACK HINTON PKWY, MCDONOUGH, GA 30253-3335
(404) 931-4127
Mailing address
565 PEACHTREE ST NE # 30308, ATLANTA, GA 30308-2230
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/23/2014
Last updated
12/23/2014
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