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1104474600
COLTON SHANNON
JACKSON, TN
NPI
1104474600
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: TN 4374)
Enumeration Date
2019-08-28
Last Update Date
2019-08-28
Business Address
Mr. COLTON SHANNON LPC-MHSP
708 N HIGHLAND AVE
JACKSON, TN 38301-4829
Phone number: 731-277-7778
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Mailing Address
Mr. COLTON SHANNON LPC-MHSP
708 N HIGHLAND AVE
JACKSON, TN 38301-4829
Phone number: 731-277-7778
Copy
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