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Individual

SHONTAE WALDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
3711 NW 21ST ST APT 307, LAUDERDALE LAKES, FL 33311-3158
(305) 834-5390
Mailing address
3711 NW 21ST ST APT 307, LAUDERDALE LAKES, FL 33311-3158
(305) 834-5390

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5250597
FL
171400000X
Health & Wellness Coach
174N00000X
Lactation Consultant (Non-RN)
225CA2500X
Assistive Technology Supplier Rehabilitation Counselor
246RP1900X
Phlebotomy Technician
251K00000X
Public Health or Welfare Agency
374J00000X
Doula
385H00000X
Respite Care
385HR2055X
Child Mental Illness Respite Care
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
385HR2065X
Child Physical Disabilities Respite Care

Other

Enumeration date
08/09/2023
Last updated
09/22/2023
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