Individual
SELINA SHANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
232 MARKET ST STE 228, FLOWOOD, MS 39232-3339
(601) 460-0730
Mailing address
223 SWAN LAKE DR, JACKSON, MS 39212-5337
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C5911
MS
Other
Enumeration date
08/07/2014
Last updated
03/17/2018
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