Provider Demographics
NPI:1659717718
Name:MACK, SHELIA BATTLE
Entity Type:Individual
Prefix:MRS
First Name:SHELIA
Middle Name:BATTLE
Last Name:MACK
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 1:718 PARTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-3044
Mailing Address - Country:US
Mailing Address - Phone:229-886-2204
Mailing Address - Fax:
Practice Address - Street 1:718 PARTRIDGE DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3044
Practice Address - Country:US
Practice Address - Phone:229-886-2204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator