Individual
MS. BRIDGETT DENISE BRAXTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6124 GOODMAN RD, JACKSONVILLE, FL 32244-1933
(901) 338-9821
Mailing address
6124 GOODMAN RD, JACKSONVILLE, FL 32244-1933
(901) 338-9821
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/20/2017
Last updated
12/20/2017
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