Individual
MS. SHEILA DIXON REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O
Contact information
Practice address
3981 SPRINGFIELD RD, SPARTA, GA 31087-3343
(706) 486-4051
Mailing address
3981 SPRINGFIELD ROADD, SPARTA, GA 31087
(706) 486-4051
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
372600000X
GA
172V00000X
Community Health Worker
033924586
GA
305R00000X
Preferred Provider Organization
Primary
033924586
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033924586
—
GA
Enumeration date
08/09/2011
Last updated
08/09/2011
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