Provider Demographics
NPI:1225473598
Name:DROGE, SHAWN ALLEN (S/T)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:ALLEN
Last Name:DROGE
Suffix:
Gender:M
Credentials:S/T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 GORDON COMMERCIAL DR STE D
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240-5754
Mailing Address - Country:US
Mailing Address - Phone:706-845-4054
Mailing Address - Fax:706-845-4430
Practice Address - Street 1:122 GORDON COMMERCIAL DR
Practice Address - Street 2:SUITE D
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240-5754
Practice Address - Country:US
Practice Address - Phone:706-845-4054
Practice Address - Fax:706-845-4054
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist