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1326390196
SHANTEL M FORSTALL
FAYETTEVILLE, GA
NPI
1326390196
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: GA CSW004681)
Enumeration Date
2012-10-03
Last Update Date
2013-01-28
Business Address
SHANTEL M FORSTALL LCSW
110 HABERSHAM DR
FAYETTEVILLE, GA 30214-1381
Phone number: 770-371-5076
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Mailing Address
SHANTEL M FORSTALL LCSW
110 HABERSHAM DR
FAYETTEVILLE, GA 30214-1381
Phone number: 770-371-5076
Copy
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