Individual
SHANTELL JERIDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1179 E 15TH ST, JACKSONVILLE, FL 32206-3206
(904) 662-6019
Mailing address
1179 E 15TH ST, JACKSONVILLE, FL 32206-3206
(904) 662-6019
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
FL
Other
Enumeration date
12/21/2024
Last updated
12/26/2024
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