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Individual

MRS. STANNETTA SHONNAE JEFFERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MED

Contact information

Practice address
1836 CARROLLTON VILLA RICA HWY STE 103, VILLA RICA, GA 30180-5193
(404) 955-8558
Mailing address
1836 CARROLLTON VILLA RICA HWY STE 103, VILLA RICA, GA 30180-5193
(404) 955-8558

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
09/15/2025
Last updated
10/24/2025
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