Individual
SHANNON BRANLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
361 ISRG BLDG #90760, ROOM #106, HURLBURT FIELD, FL 32544
(850) 884-1348
Mailing address
3250 ZEMKE AVE, TAMPA, FL 33621-5023
(813) 827-9170
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1850
AL
103TC0700X
Clinical Psychologist
Primary
1850
AL
Other
Enumeration date
10/15/2010
Last updated
07/18/2023
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