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Individual

SHAWNA JAMIE STOTTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD, LCSW

Contact information

Practice address
96 SW ALLAPATTAH RD, INDIANTOWN, FL 34956-4307
(772) 597-9400
Mailing address
1521 ALTON RD UNIT 310, MIAMI BEACH, FL 33139-3301
(305) 978-6669

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY34972
CA
103T00000X
Psychologist
PY11329
FL
103TF0200X
Forensic Psychologist
PY11329
FL
1041C0700X
Clinical Social Worker
SW14934
FL

Other

Enumeration date
05/13/2022
Last updated
05/06/2024
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