Individual provider · Type 1 NPI

Blair Evonne Shane

Mental Health Counselor · Jacksonville, FL

NPI number 1104696566 Active

Practice location

3725 Belfort Rd
Jacksonville, FL 32216-5813

Call (904) 296-1055 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XIMH26957 (FL)

Mental Health Counselor: Definition to come...

21 other providers at this address

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About NPI 1104696566

Blair Evonne Shane's National Provider Identifier is 1104696566, issued on Jan 8, 2024. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Jacksonville, FL. The record was last updated on Feb 14, 2025.