Individual
SHELLEY J DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 N CENTRAL AVE, KISSIMMEE, FL 34741-4450
(407) 530-5063
Mailing address
283 PEREGINE DR, INDIALANTIC, FL 32903
(603) 557-4820
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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