Provider Information for 1619327327
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HEATHER FOGLE SHAVER LCSW
Sex: Female
NPI: 1619327327
Last Updated: 2016-06-14
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1619327327 | ||||||||
| Enumeration Date | 2016-06-14 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 35 W PINE ST ORLANDO, FL 32801-2610 United States Phone: 407-259-8731 | Fax:407-876-4279 | ||||||||
| Primary Practice Address | 11335 COMMERCIAL ST ORLANDO, FL 32836-6216 United States Phone: 407-259-8731 | Fax: | ||||||||
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