Individual
SHANNON MONIQUE BURKHALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 TARA WAY, COVINGTON, GA 30016-8079
(470) 807-6735
Mailing address
20 TARA WAY, COVINGTON, GA 30016-8079
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
374K00000X
Religious Nonmedical Practitioner
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
05/03/2023
Last updated
05/03/2023
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