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Individual

VENUS SHANAE THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
272 BROOKLYN DR, DALLAS, GA 30132-4452
(678) 890-7102
Mailing address
272 BROOKLYN DR, DALLAS, GA 30132-4452
(678) 890-7102

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor

Other

Enumeration date
10/31/2021
Last updated
10/31/2021
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