Provider Demographics
NPI:1437844974
Name:SHAMLEE, SYNQUISITE TIERE (CSA)
Entity Type:Individual
Prefix:MRS
First Name:SYNQUISITE
Middle Name:TIERE
Last Name:SHAMLEE
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5046 BOYNTON PL APT 304
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3623
Mailing Address - Country:US
Mailing Address - Phone:757-282-9229
Mailing Address - Fax:
Practice Address - Street 1:6175 HICKORY FLAT HWY
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-7207
Practice Address - Country:US
Practice Address - Phone:404-213-5160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant