Individual
TIEASHA SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
235 NORTHSIDE DR, VALDOSTA, GA 31602-1859
(229) 531-3835
Mailing address
4301 BEMISS RD APT C101, VALDOSTA, GA 31605-6133
(229) 531-3835
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT014905
GA
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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