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Individual

SHABAKA FLETCHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
901 STONEVIEW TRL NW, LILBURN, GA 30047-7127
(404) 399-4374
Mailing address
PO BOX 264, LILBURN, GA 30048-0264
(404) 399-4974

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
3747A0650X
Attendant Care Provider
3747P1801X
Personal Care Attendant
Primary
376J00000X
Homemaker

Other

Enumeration date
07/14/2020
Last updated
07/14/2020
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