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Individual

SHAMIRA HATHORNE WYATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3729 MAIN ST, COLLEGE PARK, GA 30337-3544
(678) 615-9743
Mailing address
3729 MAIN ST, COLLEGE PARK, GA 30337-3544
(678) 615-9743

Taxonomy

Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
GA

Other

Enumeration date
07/24/2020
Last updated
07/24/2020
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