MEDICARE: OASIS NATURALIZED GOALS

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	:	1740013820
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OASIS NATURALIZED GOALS

Provider Business Mailing Address
First Line	:	9017 SANTE FE CT
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-6037
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9017 SANTE FE CT
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-6037
Country	:	US
Telephone Number	:	334-737-9546
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR/OWN
Name	:	MRS. EBONY LATRESE SHOEMO
Credential	:
Telephone Number	:	334-737-9546

Provider Enumeration Date	:	08/23/2024
Last Update Date	:	08/23/2024

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Directions to “OASIS NATURALIZED GOALS ” Practice Location

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