Individual
SHAKESHA P GANTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
(904) 781-7797
(904) 854-0504
Mailing address
7101 WILSON BLVD, #4304, JACKSONVILLE, FL 32210-3685
(904) 781-7797
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/06/2013
Last updated
02/06/2013
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