Provider Information for 1215477864
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SHIRLEY MARKS LADAC, LMFT, MAC
Sex: Female
NPI: 1215477864
Last Updated: 2021-08-17
Certification Date: 2021-08-17
Certification Date: 2021-08-17
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1215477864 | ||||||||||||
| Enumeration Date | 2017-03-01 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 2303 BARCLAY DR NASHVILLE, TN 37206-1501 United States Phone: 615-262-3497 | Fax: | ||||||||||||
| Primary Practice Address | 431 NISSAN DR STE 202 SMYRNA, TN 37167-4365 United States Phone: 615-462-7392 | Fax:615-267-0020 | ||||||||||||
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