Individual
DR. SHELIA RENEE CASSIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
307 BOATNER RD STE 114, EGLIN AFB, FL 32542-1302
(850) 883-8600
Mailing address
307 BOATNER RD STE 114, EGLIN AFB, FL 32542-1302
(850) 883-8600
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
0710P
AR
103G00000X
Clinical Neuropsychologist
PY6766
FL
103TC0700X
Clinical Psychologist
07-10P
AR
103TC0700X
Clinical Psychologist
Primary
PY6766
FL
103TF0200X
Forensic Psychologist
PY6766
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164425719
—
AR
01
—
P00399029
RAILROAD MEDICARE
AR
Enumeration date
07/28/2006
Last updated
07/21/2022
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