Individual
DANIELA TREATMENT PANET RAYMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3574 US 1 S, ST AUGUSTINE, FL 32086-6466
(904) 217-7161
Mailing address
3574 US 1 S, ST AUGUSTINE, FL 32086-6466
(904) 217-7161
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
225700000X
Massage Therapist
Primary
MA71304
FL
Other
Enumeration date
04/17/2018
Last updated
07/31/2024
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