Individual
SHAWNA P CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CBHCMS, CMHP, HS-BCP
Contact information
Practice address
2200 ROSSELLE ST, JACKSONVILLE, FL 32204-3126
(904) 551-2399
Mailing address
1401 RIVERPLACE BLVD APT 811, JACKSONVILLE, FL 32207-9079
(912) 278-0403
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
0102782
FL
Other
Enumeration date
03/05/2025
Last updated
03/18/2025
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