Individual
SHANTEL LATRELL HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1339 PARTRIDGE PL, VALDOSTA, GA 31601-6227
(229) 415-3462
Mailing address
1339 PARTRIDGE PL, VALDOSTA, GA 31601-6227
(229) 415-3462
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
GA
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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