Provider Demographics
NPI:1790140523
Name:EUBANKS-WORLDS, SHALEANA
Entity Type:Individual
Prefix:
First Name:SHALEANA
Middle Name:
Last Name:EUBANKS-WORLDS
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 1:10720 FALLOW TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-2078
Mailing Address - Country:US
Mailing Address - Phone:407-591-1146
Mailing Address - Fax:407-656-9161
Practice Address - Street 1:6889 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-6827
Practice Address - Country:US
Practice Address - Phone:407-591-1146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-21
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor