| Shontell Carswell | |
|
7407 Celeste Ln Tampa FL 33619-4103 | |
| (813) 531-0143 | |
| Not Available |
| Full Name | Shontell Carswell |
|---|---|
| Speciality | Behavior Technician |
| Location | 7407 Celeste Ln, Tampa, Florida |
| Authorized Official Name and Position | Audrey Watson (CEO) |
| Authorized Official Contact | 8132159170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shontell Carswell 7407 Celeste Ln Tampa FL 33619-4103 Ph: () - | Shontell Carswell 7407 Celeste Ln Tampa FL 33619-4103 Ph: (813) 531-0143 |
| NPI Number | 1760923122 |
|---|---|
| Provider Enumeration Date | 03/17/2017 |
| Last Update Date | 03/17/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760923122 | NPI | - | NPPES |
| 018120200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106S00000X | Behavior Technician | 018120200 (Florida) | Primary |
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