Individual
YAKEISSA SHONTA WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
747 DAVIS RD STE 200, STOCKBRIDGE, GA 30281-3015
(404) 808-5672
Mailing address
747 DAVIS RD STE 200, STOCKBRIDGE, GA 30281-3015
(404) 808-5672
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
CO26618
GA
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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