Most Relevant Information
Provider Data
| NPI Number: | 1003475252 |
| Provider Name: | SHAUNTAVIA CLINTON |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/11/2019 |
| Last Updated: | 06/11/2019 |
Provider Practice Location
1801 MICCOSUKEE COMMONS DR
TALLAHASSEE
FL
323085433
Practice Location Phone/Fax
| Phone: | 8502194234 |
| Fax: |
Provider Mailing Location
2006 E PARK AVE
TALLAHASSEE
FL
323012862
Provider Mailing Phone/Fax
| Phone: | 8502124315 |
| Fax: |