Provider Demographics
NPI:1184791170
Name:ATKINS-HARRIS, SHONDDA RENEE (CERTIFICATION)
Entity type:Individual
Prefix:MS
First Name:SHONDDA
Middle Name:RENEE
Last Name:ATKINS-HARRIS
Suffix:
Gender:F
Credentials:CERTIFICATION
Other - Prefix:MS
Other - First Name:SHONDDA
Other - Middle Name:RENEE
Other - Last Name:ATKINS-HARRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CBC
Mailing Address - Street 1:PO BOX 741322
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-1325
Mailing Address - Country:US
Mailing Address - Phone:678-541-1227
Mailing Address - Fax:
Practice Address - Street 1:5375 OAKDALE RD SE
Practice Address - Street 2:SUITE 100,
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-5251
Practice Address - Country:US
Practice Address - Phone:678-541-1227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1055-00671744R1103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1103XOther Service ProvidersSpecialistResearch Data Abstracter/Coder
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1055-0067OtherCBCS