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General NPI Number Information
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NPI Number | 1093761850
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Entity Type | Individual
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Provider Name | STEVEN J SHEA PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 09/09/2010
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Provider Practice Location Address
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Address Line | 5201 RAYMOND ST ORLANDO VA MEDICAL CENTER, MENTAL HEALTH
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City | ORLANDO
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State | FL
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Zip | 32803-8208
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Country | US
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Telephone | 321-397-6467
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Fax | 407-599-1472
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Provider Business Mailing Address
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Address Line | 5201 RAYMOND ST ORLANDO VA MEDICAL CENTER, MENTAL HEALTH
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City | ORLANDO
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State | FL
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Zip | 32803-8208
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Country | US
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Telephone | 321-397-6467
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Fax | 407-599-1472
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 507
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License Number State | SC
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