| Shanavia Natae Dickerson, | |
|
1731 Tilden Ave, Jonesboro, GA 30236-3744 | |
| (470) 549-5131 | |
| Not Available |
| Full Name | Shanavia Natae Dickerson |
|---|---|
| Gender | Female |
| Speciality | Massage Therapist |
| Location | 1731 Tilden Ave, Jonesboro, Georgia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104439975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | MT012487 (Georgia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Shanavia Natae Dickerson, 1731 Tilden Ave, Jonesboro, GA 30236-3744 Ph: (470) 549-5131 | Shanavia Natae Dickerson, 1731 Tilden Ave, Jonesboro, GA 30236-3744 Ph: (470) 549-5131 |
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