Individual
MR. DONALD EUGENE SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.A.P. #4011
Contact information
Practice address
7145 NE 199TH STREET RD, CITRA, FL 32113-2809
(352) 595-7746
Mailing address
7145 NE 199TH STREET RD, CITRA, FL 32113-2809
(352) 595-7746
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4011
FL
Other
Enumeration date
01/03/2008
Last updated
01/03/2008
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