Individual
MR. JUSTIN TYLER BOLLINGMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1650 PRUDENTIAL DR STE 210, JACKSONVILLE, FL 32207-8149
(904) 376-3800
(904) 396-4942
Mailing address
PO BOX 748519, ATLANTA, GA 30374-8519
(904) 376-3800
(904) 376-3998
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
3292
FL
Other
Enumeration date
01/06/2015
Last updated
05/13/2022
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