Individual
CARLISIA SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10874 STANDING STONE DR, WIMAUMA, FL 33598-6161
(813) 356-9020
Mailing address
10874 STANDING STONE DR, WIMAUMA, FL 33598-6161
(813) 356-9020
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1326311085
FL
Other
Enumeration date
03/21/2017
Last updated
03/21/2017
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