Individual
CONCORDIAJO WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15681 N US HIGHWAY 301, CITRA, FL 32113-3154
(352) 595-5000
Mailing address
216 NE 1ST AVE, OCALA, FL 34470-6654
(352) 732-6565
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/22/2021
Last updated
06/01/2023
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