Individual
ALUE NGOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
(904) 781-7797
(904) 781-8684
Mailing address
2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
(904) 781-7797
(904) 781-8684
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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