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1518910116
ELIZABETH BURTY SHADDEN
JACKSONVILLE, FL
NPI
1518910116
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Other Name
MARTHA ELIZABETH BURTY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: FL MH789)
Enumeration Date
2006-05-18
Last Update Date
2015-04-22
Business Address
Ms. ELIZABETH BURTY SHADDEN LMHC
655 W 8TH ST UFJP PSYCHIATRIC
JACKSONVILLE, FL 32209-6511
Phone number: 904-244-3688
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Mailing Address
Ms. ELIZABETH BURTY SHADDEN LMHC
PO BOX 44008 UFJP PROVIDER ENROLLMENT
JACKSONVILLE, FL 32231-4008
Phone number: 904-244-3199
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