Individual
AMANDA S HAWTHORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8130 BAYMEADOWS CIR W # 204-206, JACKSONVILLE, FL 32256-1880
(904) 608-9881
Mailing address
1523 IBIS DR, ORANGE PARK, FL 32065-7381
(904) 505-3998
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW20366
FL
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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