Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 10177 | FL |
Y | 103TC0700X | Clinical Psychologist | 10177 | FL |
N | 102L00000X | Psychologist | 10177 | FL |
N | 103T00000X | Psychologist | 10177 | FL |
N | 103TA0700X | Adult Development & Aging Psychologist | 10177 | FL |
N | 103G00000X | Clinical Psychologist | 10177 | FL |
N | 103TC0700X | Clinical Psychologist | 10177 | FL |
NPI | 1043663982 |
---|---|
Provider Name | Shannon Caramiello |
First Address | Tampa, FL 33629-8175 |
Second Address | Tarpon Springs, FL 34689-3656 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2016 |
Last Update Date | 19/05/2020 |