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1003575242
SHAHETAH GRAY
WARNER ROBINS, GA
NPI
1003575242
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2021-12-15
Last Update Date
2021-12-15
Business Address
SHAHETAH GRAY
940 GA HIGHWAY 96 STE A
WARNER ROBINS, GA 31088-2587
Phone number: 229-817-5454
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Mailing Address
SHAHETAH GRAY
PO BOX 1311
BYRON, GA 31008-1311
Phone number: 478-225-8060
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