Dickerson, Shanavia Natae
Dickerson, Shanavia Natae is an sole proprietor health care provider with primary practice located at 1731 Tilden Ave , Jonesboro GA 30236-3744. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as her primary health care specialty. Dickerson, Shanavia Natae can be contacted via phone (470) 549-5131.Contact Information
Primary practice address
1731 Tilden Ave
Jonesboro GA 30236-3744
Phone: (470) 549-5131
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist | 225700000X | MT012487 | Georgia |
Profile Details
| NPI number | 1104439975 |
|---|---|
| LBN Legal business name | Dickerson, Shanavia Natae |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 31st, 2020 |
| Last updated | Aug 31st, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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