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General NPI Number Information
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NPI Number | 1780085258
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Entity Type | Individual
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Provider Name | SHAMECCA DEAN
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Gender | Female
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 09/15/2014
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Provider Practice Location Address
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Address Line | 3231 SW 20TH CT
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-3733
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Country | US
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Telephone | 954-651-8211
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Fax |
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Provider Business Mailing Address
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Address Line | 3231 SW 20TH CT
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-3733
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Country | US
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Telephone | 954-651-8211
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MH11825
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License Number State | FL
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