Shanda Marie Mobley-Taylor, LPC
Counselor, Professional in Rincon, GA. Individual provider (NPI-1).
NPI number1730616004
StatusActive
Last updated in NPPESMay 4, 2022
Details
- NPI
- 1730616004
- Entity type
- Individual (NPI-1)
- Name
- Shanda Marie Mobley-Taylor
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 17, 2017
- Certification date
- May 4, 2022
- Last updated
- May 4, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 009578 | GA | Yes |
Practice location
5805 Highway 21 S Ste 18-19Rincon, GA 31326-5511
Phone 912-667-8806
Mailing address
100 Autumn DrRincon, GA 31326-5675
Phone 912-667-8806
Other practice locations
1009 N Columbia Ave
Rincon, GA 31326-6828
Rincon, GA 31326-6828
Phone 912-657-9613 · Fax 912-826-0233
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