Individual
SHAHNQUALA WINSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5500 ALYSA CT, ELLENWOOD, GA 30294-3845
(678) 687-0454
Mailing address
5500 ALYSA CT, ELLENWOOD, GA 30294-3845
(678) 687-0454
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
GA
Other
Enumeration date
05/27/2026
Last updated
05/27/2026
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