Individual
SHAKERA ANN MORRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
905 NE PRIMA VISTA BLVD STE A, PORT ST LUCIE, FL 34952-2360
(772) 634-2451
Mailing address
1166 SE PURITAN LN, PORT ST LUCIE, FL 34983-3226
(772) 634-2451
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019104900
—
FL
Enumeration date
03/14/2018
Last updated
03/14/2018
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