Individual
SHACARA MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
841 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8329
(904) 674-1316
Mailing address
11575 RIVERSTONE WAY, JACKSONVILLE, FL 32218-9507
(904) 674-1316
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
13776
FL
Other
Enumeration date
02/07/2018
Last updated
02/07/2018
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