Individual
CARLO LAVERN SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6150 METRO WEST BLVD SUITE 103, ORLANDO, FL 32811
(407) 276-2489
Mailing address
5403 EUGENIA CT, ORLANDO, FL 32811-3910
(407) 276-2489
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IMH18808
FL
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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