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General NPI Number Information
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NPI Number | 1508750506
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Entity Type | Individual
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Provider Name | SHUNTRICE STAPLETON
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Gender | Female
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 2003 STOREY MILL ESTATE DR
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City | HEPHZIBAH
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State | GA
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Zip | 30815-7807
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Country | US
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Telephone | 706-578-4367
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 193
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City | WRENS
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State | GA
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Zip | 30833-0193
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | NA
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 1813019
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License Number State | GA
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