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Individual

DR. SHANNON MARIE BARSEMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
430 MORTON PLANT ST, SUITE 402, CLEARWATER, FL 33756-3398
(727) 461-8635
(727) 333-6038
Mailing address
430 MORTON PLANT ST STE 401, CLEARWATER, FL 33756-3394
(727) 298-6025
(727) 461-8648

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY 9339
FL
103TA0700X
Adult Development & Aging Psychologist
PY 9339
FL
103TC0700X
Clinical Psychologist
PY 9339
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
023608600
FL
01
P01713937
RAILROAD MEDICARE PROVIDER NUMBER
FL
Enumeration date
07/03/2012
Last updated
03/03/2022
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