Individual
DR. SHANNON MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1201 1ST ST S STE 100A, WINTER HAVEN, FL 33880-3904
(863) 280-6080
(863) 229-7587
Mailing address
2995 DREW ST FL 2, CLEARWATER, FL 33759-3012
(727) 532-1355
(813) 635-2613
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY10219
FL
Other
Enumeration date
07/26/2018
Last updated
03/25/2021
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