Provider Demographics
NPI:1295259240
Name:MCGEE, MIA SHALON
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:SHALON
Last Name:MCGEE
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 1:801 STUBBS AVE STE E
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5566
Mailing Address - Country:US
Mailing Address - Phone:318-512-4997
Mailing Address - Fax:318-600-6095
Practice Address - Street 1:801 STUBBS AVENUE, SUITE E
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:318-512-4997
Practice Address - Fax:318-600-6095
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator