Individual
ANGELA L SHINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW, LMSW
Contact information
Practice address
110 FREESTONE RDG, COLUMBUS, MS 39701-4503
(615) 243-0670
Mailing address
PO BOX 221, COLUMBUS, MS 39703-0221
(615) 243-0670
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
—
—
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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