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Shane Thomas Raymond, L.C.S.W.

Social Worker, Clinical in Brandon, FL. Individual provider (NPI-1).

NPI number1457516692
StatusActive
Last updated in NPPESFeb 23, 2022

Details

NPI
1457516692
Entity type
Individual (NPI-1)
Name
Mr. Shane Thomas Raymond
Credential
L.C.S.W.
Sex
Male
Sole proprietor
Yes
Enumeration date
Jul 28, 2008
Certification date
Feb 23, 2022
Last updated
Feb 23, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, ClinicalSW9082FLYes

Practice location

1134 Bell Shoals Rd
Brandon, FL 33511

Phone 813-315-8648 · Fax 813-438-8973

Mailing address

1134 Bell Shoals Rd
Brandon, FL 33511

Phone 813-315-8648 · Fax 813-438-8973

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