Individual
DR. SHANNON MARIE BASHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
830 A1A N, SUITE 1, PONTE VEDRA BEACH, FL 32082-3287
(904) 273-2232
Mailing address
830 A1A N, SUITE 1, PONTE VEDRA BEACH, FL 32082-3287
(904) 273-2232
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY 1361
FL
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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