Individual
SHANNON N CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 S 11TH ST, LEESBURG, FL 34748-5765
(407) 435-2701
Mailing address
1608 SPRING LAKE RD, FRUITLAND PARK, FL 34731-5238
(407) 435-2701
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
IMT2553
FL
Other
Enumeration date
01/27/2017
Last updated
01/27/2017
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