Individual
MS. SHANNON V BARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED COSMETOLOGI
Contact information
Practice address
1205 SOUTH PARK AVENUE, SANFORD, FL 32771-2853
(386) 795-2042
Mailing address
704 WATERFALL CIRCLE, DELTONA, FL 32725-9227
(386) 795-2042
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
CL1250034
FL
224P00000X
Prosthetist
Primary
CL1250034
FL
Other
Enumeration date
03/23/2016
Last updated
02/23/2018
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