Individual
SHAHAGONY BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CIT
Contact information
Practice address
2109 FAIRBURN RD STE A, DOUGLASVILLE, GA 30135-1037
(770) 726-7958
Mailing address
708 SABLE CHASE BLVD, MCDONOUGH, GA 30253-3463
(770) 412-2532
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/16/2020
Last updated
06/16/2020
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