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Individual

DOROTHY WASHINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6316 SAN JUAN AVE STE 41A, JACKSONVILLE, FL 32210-2883
(904) 503-1153
(904) 503-1143
Mailing address
6316 SAN JUAN AVE STE 41A, JACKSONVILLE, FL 32210-2883
(904) 503-1153
(904) 503-1143

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
83-0766373
FL
Enumeration date
01/15/2019
Last updated
07/30/2022
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