Individual
MRS. DEBORAH L SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1980 N ATLANTIC AVE, SUITE 515, COCOA BEACH, FL 32931-5213
(321) 501-2328
(321) 799-1109
Mailing address
108 JAMAICA DR, COCOA BEACH, FL 32931-3213
(407) 920-2344
(321) 799-1109
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW2551
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z6252
BCBS
FL
Enumeration date
05/08/2006
Last updated
06/11/2015
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