Provider Demographics
NPI:1538355094
Name:STEPHENS, ASHANDA FELICIA (DC)
Entity type:Individual
Prefix:DR
First Name:ASHANDA
Middle Name:FELICIA
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2245 GODBY ROAD
Mailing Address - Street 2:STE. 202-B
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349
Mailing Address - Country:US
Mailing Address - Phone:404-935-4122
Mailing Address - Fax:404-935-0381
Practice Address - Street 1:2245 GODBY ROAD
Practice Address - Street 2:STE. 202-B
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349
Practice Address - Country:US
Practice Address - Phone:404-935-4122
Practice Address - Fax:404-935-0381
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008245111N00000X
VA0104556584111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor