Individual provider · Type 1 NPI

Jessica Miranda Shine

Professional Counselor · Augusta, GA

NPI number 1922725571 Active

Practice location

2967 Clarkston Rd
Augusta, GA 30909-9221

Call (470) 645-1541 Map

Fax (706) 685-1218

Other practice locations

  • 1343 Terrell Mill Rd SE Ste 228, Marietta, GA 30067-9472 · (770) 635-8505

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor 101YP2500XAPC008605 (GA)
Professional Counselor Primary 101YP2500XLPC014201 (GA)

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About NPI 1922725571

Jessica Miranda Shine's National Provider Identifier is 1922725571, issued on Oct 25, 2022. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Augusta, GA. The record was last updated on Oct 11, 2023.