| Doctor Name: | SHAUN T. EILDERS |
| NPI Number: | 1578808101 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 003677 |
| Business Practice Address: | 5671 Boys Ranch Rd Hahira, GA - 316322582 |
| Business Phone Number: | 2295602692 |
| Business Fax Number: | |
| Mailing Address: | Po Box 162, HAHIRA |
| State: | GA |
| Postal Code: | 316320162 |
| Phone Number: | 2295602692 |
| Fax Number: | 2297940079 |
| NPI Enumeration Date: | 12/08/2012 |
| NPI Last Update Date: | 12/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 003677 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |