Individual
JACQUELINE MONGEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
910 N JEFFERSON ST, JACKSONVILLE, FL 32209-6810
(904) 616-3455
Mailing address
910 N JEFFERSON ST, JACKSONVILLE, FL 32209-6810
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
04/28/2017
Last updated
03/10/2023
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