Individual
EARLYSSIA AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 S RIDGEWOOD AVE, SUITE 32, DAYTONA BEACH, FL 32114-7164
(386) 304-7600
Mailing address
2400 S RIDGEWOOD AVE, SUITE 32, DAYTONA BEACH, FL 32114-7164
(386) 304-7600
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/12/2016
Last updated
04/19/2016
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