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1114639119
SHANNON SIDNEY BROOM
JONESBORO, GA
NPI
1114639119
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: RI ISW03720)
Enumeration Date
2022-12-21
Last Update Date
2022-12-21
Business Address
SHANNON SIDNEY BROOM LCSW
630 MILL CREEK TRL
JONESBORO, GA 30238-4122
Phone number: 251-604-1522
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Mailing Address
SHANNON SIDNEY BROOM LCSW
630 MILL CREEK TRL
JONESBORO, GA 30238-4122
Phone number: 251-604-1522
Copy
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