Individual
SHANTA DEVAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
846 N GRIFFITH AVE, CRYSTAL RIVER, FL 34429-7669
(352) 302-6468
Mailing address
846 N GRIFFITH AVE, CRYSTAL RIVER, FL 34429-7669
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
79903
FL
Other
Enumeration date
03/03/2025
Last updated
03/03/2025
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