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Organization
SOUTHSIDE COUNSELING BIOFEEDBACK & STRESS MANAGEMENT CENTER, INC
Active
Organization
SOUTHSIDE COUNSELING BIOFEEDBACK & STRESS MANAGEMENT CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA G. STANFORD (CHIEF EXECUTIVE)
(904) 396-9144
Entity
Organization
Contact information
Practice address
4943 BEACH BLVD, JACKSONVILLE, FL 32207-4802
(904) 396-9144
Mailing address
4943 BEACH BLVD, JACKSONVILLE, FL 32207-4802
(904) 396-9144
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH 1539
FL
Other
Enumeration date
10/05/2016
Last updated
10/05/2016
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