Provider Demographics
NPI:1932731239
Name:TROMBLEY, SHANNON T (MS, APC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:T
Last Name:TROMBLEY
Suffix:
Gender:F
Credentials:MS, APC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 W MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-4122
Mailing Address - Country:US
Mailing Address - Phone:470-928-1661
Mailing Address - Fax:
Practice Address - Street 1:702 W MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-4122
Practice Address - Country:US
Practice Address - Phone:404-309-5481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC007234101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional