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1154080828
CHILLIQUA SHONTA MANIGAULT
GAINESVILLE, FL
NPI
1154080828
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: FL SW19219)
Enumeration Date
2021-12-10
Last Update Date
2021-12-10
Business Address
CHILLIQUA SHONTA MANIGAULT LCSW
1601 SW ARCHER RD
GAINESVILLE, FL 32608-1135
Phone number: 352-548-6000
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Mailing Address
CHILLIQUA SHONTA MANIGAULT LCSW
3724 NW 24TH BLVD APT 203
GAINESVILLE, FL 32605-5661
Phone number:
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