Individual
SHAKILA KEON MCKISSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HS
Contact information
Practice address
220 SW 2ND ST, POMPANO BEACH, FL 33060-4611
(954) 941-9828
(954) 941-9808
Mailing address
11031 NE 6TH AVE, MIAMI, FL 33161-7182
(305) 398-6100
(305) 757-4465
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/12/2010
Last updated
05/12/2010
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