Individual
SHANNON JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
601 FOOTE ST, CORINTH, MS 38834-4834
(662) 287-4424
(662) 287-2070
Mailing address
PO BOX 839, CORINTH, MS 38835-0839
(662) 286-9883
(662) 283-9836
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9286
TN
Other
Enumeration date
11/21/2011
Last updated
11/21/2011
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