MEDICARE: MISS SHAWANDA ANDREWS

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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1679111868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SHAWANDA ANDREWS

Provider Business Mailing Address
First Line	:	4362 MIDMOST DR STE G
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36609-5513
Country	:	US
Telephone Number	:	251-414-3599
Fax Number	:	251-217-4624

Provider Business Practice Location Address
First Line	:	4362 MIDMOST DR STE G
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36609-5513
Country	:	US
Telephone Number	:	251-414-3599
Fax Number	:	251-217-4624

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2019
Last Update Date	:	12/18/2019

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Directions to “ MISS SHAWANDA ANDREWS ” Practice Location

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