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Individual

SHANITA ANN MCCALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
162 BLAKE AVE, JACKSON, GA 30233-5557
(122) 950-7654
Mailing address
162 BLAKE AVE, JACKSON, GA 30233-5557
(122) 950-7654

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
104100000X
Social Worker
225XM0800X
Mental Health Occupational Therapist

Other

Enumeration date
06/04/2021
Last updated
06/04/2021
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