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SHANAVIA NATAE DICKERSON
NPI 1104439975
Massage Therapist in Jonesboro, GA

Active since August 31, 2020
1731 TILDEN AVE, JONESBORO, GA 30236(470) 549-5131 Get Directions Write a Review

NPPES record last updated: August 31, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shanavia Natae Dickerson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANAVIA NATAE DICKERSON (NPI 1104439975) is an individual massage therapist in Jonesboro, Georgia, licensed in Georgia (MT012487) and active in the NPI registry since August 2020.

NPPES Registry Identity

NPI1104439975
Entity TypeIndividualFemale
Primary Taxonomy225700000X
Provider Legal NameSHANAVIA NATAE DICKERSON
Location Address1731 TILDEN AVEJonesboro, GA 30236-3744
Mailing Address1731 Tilden AveJonesboro, GA 30236-3744 · (470) 549-5131
Phone(470) 549-5131
Sole ProprietorYes
Enumeration DateAugust 31, 2020
NPPES CertifiedAugust 31, 2020
✔ NPI 1104439975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in GA · MT012487
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
1731 TILDEN AVE, Jonesboro, GA 30236
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shanavia Dickerson's NPI number?

The NPI number for Shanavia Dickerson is 1104439975. It was assigned to this individual provider in the NPPES registry on August 31, 2020.

Where is Shanavia Dickerson located?

Shanavia Dickerson practices at 1731 Tilden Ave, Jonesboro, GA 30236. The listed phone number is (470) 549-5131.

What is Shanavia Dickerson's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Shanavia Dickerson was last updated on August 31, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.