Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | ISW15772 | FL |
NPI | 1003481748 |
---|---|
Provider Name | Shainna Bey |
First Address | Jacksonville, FL 32218-9110 |
Second Address | Winter Park, FL 32792-2541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2021 |
Last Update Date | 25/05/2021 |