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Individual

MRS. CYNTHIA ANN SHANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3763 EVANS AVE, FORT MYERS, FL 33901-9302
(239) 333-1609
Mailing address
3763 EVANS AVE, FORT MYERS, FL 33901-9302
(239) 333-1609

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
05/03/2017
Last updated
05/03/2017
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