Individual
SHAKITA D ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1408 S 13TH ST, CORDELE, GA 31015-3950
(229) 699-1700
Mailing address
PO BOX 1417, HINESVILLE, GA 31310-8417
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/02/2017
Last updated
10/02/2017
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