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SHANNON WADEY LCSW

Clinical >> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1649613472

Individual Registrant:
 SHANNON  WADEY LCSW
Gender: F
Sole Proprietor

Location and contact information for practice:
24719 SE 101ST AVE  HAWTHORNE, FL 32640-7663 US
Tel: 352-215-4556  Fax: --

Contact information for business:
24719 SE 101ST AVE  HAWTHORNE, FL 32640-7663 US
Tel: 352-215-4556  Fax: --

Registration Information:
NPI: 1649613472
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
Clinical
FLSW 8595

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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