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Individual

SHANTA LAFAYE WATKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
103 ASHLUND DR, CENTERVILLE, GA 31028-1262
(478) 733-9461
Mailing address
103 ASHLUND DR, CENTERVILLE, GA 31028-1262
(478) 733-9461

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
374U00000X
Home Health Aide
Primary
376K00000X
Nurse's Aide

Other

Enumeration date
07/09/2020
Last updated
07/09/2020
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