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Individual

SHAKYRA TATYANA MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1799 EDGEFIELD RD STE A, NORTH AUGUSTA, SC 29860-5306
(803) 341-8343
Mailing address
1799 EDGEFIELD RD STE A, NORTH AUGUSTA, SC 29860-5306
(803) 341-8343

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
SC
133N00000X
Nutritionist
133NN1002X
Nutrition Education Nutritionist
SC
171400000X
Health & Wellness Coach
SC
226300000X
Kinesiotherapist
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
302611321
SC
05
850000309
SC
Enumeration date
07/14/2021
Last updated
10/27/2025
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