Individual
SHAKIA COOKS FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAPC
Contact information
Practice address
2705 DAVIS MILL RD, HEPHZIBAH, GA 30815-6912
(706) 414-8257
Mailing address
2705 DAVIS MILL RD, HEPHZIBAH, GA 30815-6912
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC006925
GA
Other
Enumeration date
11/05/2019
Last updated
11/05/2019
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