Individual
JUSTIN FORREST DEMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4925 ATLANTIC VW, SAINT AUGUSTINE, FL 32080-7139
(662) 315-8357
Mailing address
4925 ATLANTIC VW, SAINT AUGUSTINE, FL 32080-7139
(662) 315-8357
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW14624
FL
Other
Enumeration date
12/05/2017
Last updated
06/26/2023
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