Individual
JACQULLIA WHITLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2051 MARTIN LUTHER KING JR BLVD, RIVIERA BEACH, FL 33404-7004
(561) 683-9995
Mailing address
2051 MARTIN LUTHER KING JR BLVD, RIVIERA BEACH, FL 33404-7004
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/23/2011
Last updated
09/23/2011
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