Individual
SHANIQUA POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
547 E LEE ST, DAWSON, GA 39842-1555
(229) 338-0602
Mailing address
547 E LEE ST, DAWSON, GA 39842-1555
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/02/2021
Last updated
05/15/2025
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