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NPI Code Detail

MEDICARE: SHALONDA STURGIS

MEDICARE: SHALONDA STURGIS
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
1106S00000XBehavior TechnicianRBT-22-220214GA

General Provider Information

NPI Number : 1639809775
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHALONDA STURGIS
Provider Business Mailing Address
First Line : 525 8TH ST
Second Line : P.O. BOX 2567
City : AUGUSTA
State : GA
Zip : 30901-2355
Country : US
Telephone Number : 706-842-5330
Fax Number : 706-842-5340
Provider Business Practice Location Address
First Line : 601 INSPERON DR
Second Line :
City : GROVETOWN
State : GA
Zip : 30813-0609
Country : US
Telephone Number : 706-842-5330
Fax Number : 706-842-5340
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2022
Last Update Date : 06/13/2022

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Directions to “ SHALONDA STURGIS ” Practice Location

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