| Shades Of Gray Wellness Center | |
|
2330 Scenic Hwy S Suite 115 Snellville GA 30078-3115 | |
| (770) 559-9919 | |
| (404) 891-5095 |
| Full Name | Shades Of Gray Wellness Center |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2330 Scenic Hwy S, Snellville, Georgia |
| Authorized Official Name and Position | Geneva Gray (COO) |
| Authorized Official Contact | 7705599919 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shades Of Gray Wellness Center 2330 Scenic Hwy S Suite 115 Snellville GA 30078-3115 Ph: (770) 559-9919 | Shades Of Gray Wellness Center 2330 Scenic Hwy S Suite 115 Snellville GA 30078-3115 Ph: (770) 559-9919 |
| NPI Number | 1235487919 |
|---|---|
| Provider Enumeration Date | 08/28/2012 |
| Last Update Date | 08/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235487919 | NPI | - | NPPES |
| 922721756B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC004236 (Georgia) | Primary |
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