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1881016996
SHANTAVIA CHANEL CARTER
JACKSONVILLE, FL
NPI
1881016996
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
222Q00000X Developmental Therapist
Enumeration Date
2014-01-08
Last Update Date
2014-01-08
Business Address
-- SHANTAVIA CHANEL CARTER
12276 SAN JOSE BLVD 580
JACKSONVILLE, FL 32223-8628
Phone number: 904-886-3228
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Mailing Address
-- SHANTAVIA CHANEL CARTER
12276 SAN JOSE BLVD 580
JACKSONVILLE, FL 32223-8628
Phone number: 904-886-3228
Copy
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