Individual
KELLEY SHYNELLE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1730 OLD HICKORY ST, DECATUR, GA 30032-4356
(678) 789-4261
Mailing address
1730 OLD HICKORY ST, DECATUR, GA 30032-4356
(678) 789-4261
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
01/16/2018
Last updated
01/16/2018
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