Individual
GEORGIA SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5515 CLARCONA POINTE WAY APT 707, ORLANDO, FL 32810-3275
(941) 565-9949
Mailing address
5515 CLARCONA POINTE WAY APT 707, ORLANDO, FL 32810-3275
(941) 565-9949
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
FL
372600000X
Adult Companion
—
FL
3747A0650X
Attendant Care Provider
Primary
—
FL
3747P1801X
Personal Care Attendant
—
FL
374U00000X
Home Health Aide
—
FL
Other
Enumeration date
11/06/2016
Last updated
11/06/2016
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