Individual
SHANTELL HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
3585 NE 207TH ST, C-9 #741, AVENTURA, FL 33180-3772
(407) 402-0129
Mailing address
3585 NE 207TH ST, C-9 #741, AVENTURA, FL 33180-3772
(407) 402-0129
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
IMT2197
FL
Other
Enumeration date
05/24/2016
Last updated
05/24/2016
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