Individual provider · Type 1 NPI
Shantreze Deshae Anderson
Professional Counselor · Lagrange, UM
NPI number
1306202007
Active
Practice location
102 Main Street, Suite 228
Lagrange, UM 30240
Mailing address
114 Jasmine Ln
Lagrange, GA 30241-8358
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | None listed |
Professional Counselor: Definition to come...
About NPI 1306202007
Shantreze Deshae Anderson's National Provider Identifier is 1306202007, issued on Jan 11, 2016. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Lagrange, UM. The record was last updated on Jan 11, 2016.