Individual
TYESHA SHADDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
417 AVOCET SEA LN, MCDONOUGH, GA 30253-4252
(770) 685-8233
Mailing address
417 AVOCET SEA LN, MCDONOUGH, GA 30253-4252
(770) 685-8233
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
04/08/2025
Last updated
04/08/2025
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