Provider Demographics
NPI:1790902336
Name:DOWNS, SHANNON DAMMANN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:DAMMANN
Last Name:DOWNS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:SHANNON
Other - Middle Name:MAYS
Other - Last Name:DAMMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1133 HANCOCK DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-2513
Mailing Address - Country:US
Mailing Address - Phone:404-237-2826
Mailing Address - Fax:
Practice Address - Street 1:1133 HANCOCK DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-2513
Practice Address - Country:US
Practice Address - Phone:404-237-2826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002306103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist