Individual
DESTINY SHEA SHACKLEFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3010 HAMILL RD, HIXSON, TN 37343-3322
(615) 810-8180
Mailing address
107 TWIN HILLS DR, MADISON, TN 37115-2242
(615) 810-8180
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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