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General NPI Number Information
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NPI Number | 1649667478
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Entity Type | Individual
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Provider Name | SHELBRA CULLUM
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Gender | Female
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 11/17/2023
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Provider Practice Location Address
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Address Line | 1911 ALAN AVE
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City | AIKEN
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State | SC
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Zip | 29801-9484
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Country | US
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Telephone | 803-439-3077
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Fax |
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Provider Business Mailing Address
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Address Line | 1285 MARKS CHURCH RD STE A
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City | AUGUSTA
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State | GA
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Zip | 30909-2472
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Country | US
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Telephone | 706-310-8441
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Fax | 706-230-4120
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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