Individual
DR. RICHARD E SHOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
800 KENNESAW AVE NW STE 320, MARIETTA, GA 30060-7945
(770) 514-0111
(404) 592-4648
Mailing address
2001 DUNCAN DR NW UNIT 2714, KENNESAW, GA 30156-0465
(770) 514-0111
(404) 592-4648
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1908
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00577607A
—
GA
Enumeration date
12/18/2006
Last updated
02/28/2022
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