Provider Demographics
NPI:1205024577
Name:SPRINGER, SHAUNA H
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:H
Last Name:SPRINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 NW 40TH TER
Mailing Address - Street 2:SUITE B
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-5813
Mailing Address - Country:US
Mailing Address - Phone:352-336-2888
Mailing Address - Fax:352-371-1730
Practice Address - Street 1:2121 NW 40TH TER
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-5813
Practice Address - Country:US
Practice Address - Phone:352-336-2888
Practice Address - Fax:352-371-1730
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7591103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist