Individual
DELOIS SHIPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8942 6TH AVE, JACKSONVILLE, FL 32208-2126
(904) 766-1850
Mailing address
8942 6TH AVE, JACKSONVILLE, FL 32208-2126
(904) 766-1850
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
AF33
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141412700
—
FL
Enumeration date
01/10/2015
Last updated
01/10/2015
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