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Individual

SHANTELL FALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
448 FREEDOM RD, WHITE HALL, AL 36040-4419
(678) 789-7663
Mailing address
414 LADY GUINEVERE WAY, JONESBORO, GA 30236-1720
(678) 789-7663

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
AL
172V00000X
Community Health Worker
AL
3747P1801X
Personal Care Attendant
AL

Other

Enumeration date
08/24/2024
Last updated
08/26/2024
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