Individual
MS. SHENITTA GUYTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
619 GRECKEN GRN, PEACHTREE CITY, GA 30269
(404) 820-2760
Mailing address
POBOX 1181, FAYETTEVILLE, GA 30214
(404) 820-2760
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
222112639987
—
GA
Enumeration date
07/25/2019
Last updated
07/25/2019
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