Individual
SHAQUANA JANEISHA DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HAIR LOSS SPECIALIST
Contact information
Practice address
1249 EVERGREEN TRL, LITHONIA, GA 30058-3115
(854) 208-3668
Mailing address
1249 EVERGREEN TRL, LITHONIA, GA 30058-3115
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
10/05/2024
Last updated
10/05/2024
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