Individual
MIA ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CBHCMS
Contact information
Practice address
463142 STATE ROAD 200, YULEE, FL 32097-5554
(904) 225-8280
Mailing address
463142 STATE ROAD 200, YULEE, FL 32097-5554
(904) 225-8280
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CBHCMS100937
FL
Other
Enumeration date
07/20/2020
Last updated
07/20/2020
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