Individual
SHANTAVIES DIOR MORNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PP
Contact information
Practice address
919 LAWYERS LN, COLUMBUS, GA 31906-3129
(706) 256-3200
Mailing address
2412 CLOVER LN, COLUMBUS, GA 31903-1220
(706) 405-9702
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
02/11/2019
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