Individual
EMILIE JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
518 SW PRIMA VISTA BLVD, PORT ST LUCIE, FL 34983-8734
(305) 504-1295
Mailing address
1326 SE BUCKINGHAM TER, PORT ST LUCIE, FL 34952-4102
(305) 504-1295
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/13/2024
Last updated
09/20/2024
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