Individual
SHANEQUA MUSSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC11
Contact information
Practice address
229 S DAVIS RD, LAGRANGE, GA 30241-2608
(800) 805-6989
Mailing address
6872 OMAHA DR., MIDLAND, GA 31820
(706) 304-9675
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1131
GA
Other
Enumeration date
05/03/2024
Last updated
05/03/2024
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