MEDICARE: SHAQUINA RAINEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	9703	GA

General Provider Information

NPI Number	:	1134642846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAQUINA RAINEY

Provider Business Mailing Address
First Line	:	181 SWINDON DR
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-6908
Country	:	US
Telephone Number	:	770-377-3935
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 PEACHTREE ST NE, SUITE 500
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30213
Country	:	US
Telephone Number	:	770-377-3935
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2017
Last Update Date	:	07/03/2024

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Directions to “ SHAQUINA RAINEY ” Practice Location

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