Organization
SHANLIS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE G WILLIAMS PH.D. (CLINICAL DIRECTOR)
(772) 223-9988
Entity
Organization
Contact information
Practice address
744 COLROADO AVE, STUART, FL 34994-2918
(772) 223-9988
(772) 223-9593
Mailing address
744 COLROADO AVE, STUART, FL 34994-2918
(772) 223-9988
(772) 223-9593
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY5917
FL
Other
Enumeration date
10/16/2013
Last updated
10/10/2016
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