Most Relevant Information
Provider Data
| NPI Number: | 1003033077 |
| Provider Name: | SHANISHA DENISE AUGUSTINE BA |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/19/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
2499 W SHAW AVE
FRESNO
CA
937113329
Practice Location Phone/Fax
| Phone: | 5592490395 |
| Fax: |
Provider Mailing Location
2499 W SHAW AVE
FRESNO
CA
937113329
Provider Mailing Phone/Fax
| Phone: | 5592490395 |
| Fax: |