Individual
WYVETTE PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 13TH ST N, JACKSONVILLE BEACH, FL 32250-3682
(727) 741-3405
Mailing address
14736 FERN HAMMOCK DR, JACKSONVILLE, FL 32258-5127
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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