Provider Demographics
NPI:1114765773
Name:ALLEN, SHAKERRIA ONAISA
Entity type:Individual
Prefix:
First Name:SHAKERRIA
Middle Name:ONAISA
Last Name:ALLEN
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 1:2555 COBB PKWY NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-3466
Mailing Address - Country:US
Mailing Address - Phone:762-667-6700
Mailing Address - Fax:
Practice Address - Street 1:2555 COBB PKWY NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-3466
Practice Address - Country:US
Practice Address - Phone:762-667-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician