Organization
J NICHOLAS PREWETT PHD & ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANN NICHOLAS PREWETT PH.D. (LICENSED PSYCHOLOGIST)
(904) 269-6071
Entity
Organization
Contact information
Practice address
1726 KINGSLEY AVE, SUITE 12, ORANGE PARK, FL 32073-4463
(904) 269-6071
(904) 269-6642
Mailing address
1726 KINGSLEY AVE, SUITE 12, ORANGE PARK, FL 32073-4463
(904) 269-6071
(904) 269-6642
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH6231
FL
103TC0700X
Clinical Psychologist
Primary
PY4331
FL
Other
Enumeration date
01/04/2007
Last updated
03/24/2008
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