Organization
SERENITY LANDING THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHAWN MARIE NICCOLLS LCSW (OWNER)
(352) 559-4477
Entity
Organization
Contact information
Practice address
2339 SABASTIAN ST, MOUNT DORA, FL 32757-8713
(352) 559-4477
Mailing address
2339 SABASTIAN ST, MOUNT DORA, FL 32757-8713
(352) 559-4477
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SW9197
FL
Other
Enumeration date
12/09/2017
Last updated
12/09/2017
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