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General NPI Number Information
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NPI Number | 1477114080
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Entity Type | Individual
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Provider Name | TESHAWAN SHAQUANA CHAMBERS
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Gender | Female
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 175 GWINNETT DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-8444
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Country | US
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Telephone | 678-209-2394
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 BARONE AVE NE APT 5112
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City | BROOKHAVEN
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State | GA
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Zip | 30329-1865
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Country | US
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Telephone | 347-531-6290
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | LPN103887
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License Number State | GA
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