Individual
DONNA SHIPES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1834 SE MANDRAKE CIR, PORT SAINT LUCIE, FL 34952-6945
(772) 971-5532
Mailing address
1834 SE MANDRAKE CIR, PORT SAINT LUCIE, FL 34952-6945
(772) 971-5532
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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