Provider Information for 1013446194
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Mrs. SHAWNDRE MARIE LEYDON LMHC
Sex: Female
NPI: 1013446194
Last Updated: 2024-11-20
Certification Date: 2024-11-20
Certification Date: 2024-11-20
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1013446194 | ||||||||
| Enumeration Date | 2017-06-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1680 SW BAYSHORE BLVD STE 233 PORT ST LUCIE, FL 34984-3519 United States Phone: 772-353-2485 | Fax:772-264-6291 | ||||||||
| Primary Practice Address | 1680 SW BAYSHORE BLVD SUITE 233 PORT ST LUCIE, FL 34984-8774 United States Phone: 772-353-2485 | Fax: | ||||||||
| Secondary Practice Address(es) | 1061 PLEASANT ST | ||||||||
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