Individual
MS. SHANNON CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(973) 941-8322
Mailing address
507 NW 39TH RD, #309, GAINESVILLE, FL 32607-2322
(973) 941-8322
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05652700
NJ
Other
Enumeration date
07/23/2013
Last updated
12/09/2014
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