Individual
SHANE FERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1061 HARMON AVE BLDG 302, FORT STEWART, GA 31314-5641
(912) 435-5799
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6965
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810006219
VA
Other
Enumeration date
09/06/2017
Last updated
01/19/2024
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