Individual
SHAUNTRELL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
229 S DAVIS RD, LAGRANGE, GA 30241-2608
(800) 805-6989
Mailing address
229 S DAVIS RD, LAGRANGE, GA 30241-2608
(800) 805-6989
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5320G
AL
Other
Enumeration date
06/18/2024
Last updated
06/18/2024
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