| Doctor Name: | MRS. MARY JUANITA SHAKES |
| NPI Number: | 1083785182 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 0113C |
| Business Practice Address: | 205 Herbert Street Demopolis, AL - 36732 |
| Business Phone Number: | 3343417400 |
| Business Fax Number: | 6014855215 |
| Mailing Address: | P.o. Box 1127, DEMOPOLIS |
| State: | AL |
| Postal Code: | 36732 |
| Phone Number: | 3343417400 |
| Fax Number: | 3342872331 |
| NPI Enumeration Date: | 11/11/2006 |
| NPI Last Update Date: | 08/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 0113C |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |