Individual
SHENNA MICHELLE CLYBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3112 DELAWARE AVE, FORT PIERCE, FL 34947-3531
(772) 666-0672
Mailing address
3112 DELAWARE AVE, FORT PIERCE, FL 34947-3531
(772) 666-0672
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
FL
Other
Enumeration date
10/08/2020
Last updated
10/08/2020
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