Doctor Name: | SHADIA NOVA SISK |
NPI Number: | 1700929429 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | |
Business Practice Address: | 162 County Services Rd Suite 1 Ashland City, TN - 37015 |
Business Phone Number: | 6155179417 |
Business Fax Number: | |
Mailing Address: | 7204 S Colony Dr, NASHVILLE |
State: | TN |
Postal Code: | 372213931 |
Phone Number: | 6159576936 |
Fax Number: | |
NPI Enumeration Date: | 02/14/2007 |
NPI Last Update Date: | 11/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YS0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | School |
Taxonomy Definition: |