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General NPI Number Information
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NPI Number | 1558838227
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Entity Type | Individual
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Provider Name | TRACI E. SHELTON MA, CRC
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Gender | Female
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Dates
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Enumeration Date | 10/30/2018
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Last Update Date | 10/30/2018
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Provider Practice Location Address
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Address Line | 50 LENOX POINTE NE STE A
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City | ATLANTA
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State | GA
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Zip | 30324-3170
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Country | US
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Telephone | 678-824-6590
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Fax | 678-228-1258
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Provider Business Mailing Address
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Address Line | 2980 CREEL RD
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City | COLLEGE PARK
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State | GA
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Zip | 30349-4948
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Country | US
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Telephone | 404-798-6928
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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 | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State | GA
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