Individual
MRS. JESSICA M. SHAUGHNESSY-MALLOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
101 S 10TH ST, HAINES CITY, FL 33844-5303
(863) 412-9197
Mailing address
101 S 10TH ST, HAINES CITY, FL 33844-5303
(863) 412-9197
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA31036
FL
Other
Enumeration date
09/25/2012
Last updated
09/25/2012
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