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Individual

MRS. SHATARRA TAVONIA SALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, FNP-C, PMHNP

Contact information

Practice address
13455 E WADE HAMPTON BLVD STE 17, GREER, SC 29651-6276
(864) 551-2384
(864) 499-2697
Mailing address
PO BOX 749306, ATLANTA, GA 30374-9306
(864) 968-9144
(864) 968-9244

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
24906
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
24906
SC

Other

Enumeration date
06/23/2020
Last updated
05/30/2025
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