Individual
ANTONIESHA AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8805 NORFOLK BLVD, JACKSONVILLE, FL 32208-1917
(904) 343-2218
Mailing address
PO BOX 66054, JACKSONVILLE, FL 32208-6054
(904) 343-2218
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
FL
Other
Enumeration date
06/13/2017
Last updated
06/13/2017
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