Provider Demographics
NPI:1609561976
Name:BELLAMY, SHAJERA
Entity Type:Individual
Prefix:
First Name:SHAJERA
Middle Name:
Last Name:BELLAMY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 ATLAS DR
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-2879
Mailing Address - Country:US
Mailing Address - Phone:718-755-6133
Mailing Address - Fax:
Practice Address - Street 1:2476 US HIGHWAY 280
Practice Address - Street 2:
Practice Address - City:AILEY
Practice Address - State:GA
Practice Address - Zip Code:30410-3538
Practice Address - Country:US
Practice Address - Phone:404-924-6220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician