Individual
DR. GAVIN D SHOAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
619 S MARION AVE, UNIT 9, LAKE CITY, FL 32025-5808
(386) 755-3016
Mailing address
619 S MARION AVE, UNIT 9, LAKE CITY, FL 32025-5808
(386) 755-3016
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 7393
FL
Other
Enumeration date
10/06/2006
Last updated
07/08/2007
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