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General NPI Number Information
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NPI Number | 1932731239
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Entity Type | Individual
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Provider Name | SHANNON T TROMBLEY MS, APC, NCC
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Gender | Female
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Dates
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Enumeration Date | 02/05/2020
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 702 W MEMORIAL DR
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City | DALLAS
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State | GA
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Zip | 30132-4122
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Country | US
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Telephone | 404-309-5481
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Fax |
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Provider Business Mailing Address
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Address Line | 702 W MEMORIAL DR
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City | DALLAS
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State | GA
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Zip | 30132-4122
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Country | US
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Telephone | 470-928-1661
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | APC007234
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License Number State | GA
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