Individual
MRS. SHELLEY SMITH GRENEKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1811 GREEN CIR STE B, VALDOSTA, GA 31602-2784
(229) 244-9688
Mailing address
1811 GREEN CIR STE B, VALDOSTA, GA 31602-2784
(229) 244-9688
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001535
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001535
001535
GA
Enumeration date
03/23/2017
Last updated
05/14/2019
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