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Individual

SHAQUANA KELLUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PEER SPECIALIST

Contact information

Practice address
800 3RD AVE FRNT A, NEW YORK, NY 10022-7604
(518) 225-5069
Mailing address
4 SUMMIT HILL WAY APT 402, TROY, NY 12180-6346

Taxonomy

Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
171M00000X
Case Manager/Care Coordinator
175T00000X
Peer Specialist
Primary

Other

Enumeration date
12/15/2025
Last updated
12/15/2025
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