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Phantashia Shine
NPI 1780444570 · on the registry since 2024
Practice
- Address
- 6647 Chircahua Dr
Lithonia, GA 30038 - Phone
- (770) 771-8741
Registry record
- Primary taxonomy
- 106S00000X
106S00000X
- Licence states on file
- NULL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-03-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia