Doctor Name: | DR. SHANNON LYNETTE CROSSLIN |
NPI Number: | 1275961039 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | LPC006797 |
Business Practice Address: | 608 Saint Christopher Ln Ellenwood, GA - 302942999 |
Business Phone Number: | 7703166582 |
Business Fax Number: | 6782840506 |
Mailing Address: | 608 Saint Christopher Ln, ELLENWOOD |
State: | GA |
Postal Code: | 302942999 |
Phone Number: | 7703166582 |
Fax Number: | 6782840506 |
NPI Enumeration Date: | 10/14/2013 |
NPI Last Update Date: | 10/14/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LPC006797 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |