Most Relevant Information
Provider Data
| NPI Number: | 1003225970 |
| Provider Name: | STANVONNA SHOOTES |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/05/2014 |
| Last Updated: | 08/05/2014 |
Provider Practice Location
435 CLARK RD
SUITE 107
JACKSONVILLE
FL
322185596
Practice Location Phone/Fax
| Phone: | 9047650665 |
| Fax: | 9047650664 |
Provider Mailing Location
6535 SUNSET DR
JACKSONVILLE
FL
322084637
Provider Mailing Phone/Fax
| Phone: | 9044850715 |
| Fax: | 9047650664 |