Doctor Name: | DR. KATHLEEN SHEA |
NPI Number: | 1053701888 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | SS1134 |
Business Practice Address: | 2706 Alt 19n, Suite 214 Palm Harbor, FL - 346832641 |
Business Phone Number: | 7277860600 |
Business Fax Number: | |
Mailing Address: | 2706 Alt 19n, Suite 214, PALM HARBOR |
State: | FL |
Postal Code: | 346832641 |
Phone Number: | 7277860600 |
Fax Number: | |
NPI Enumeration Date: | 02/02/2015 |
NPI Last Update Date: | 02/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | SS1134 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |