Individual
MRS. JACQUELINE SMITH-BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
5831 LISKA DR, JACKSONVILLE, FL 32244-2183
(904) 651-6049
Mailing address
5831 LISKA DR, JACKSONVILLE, FL 32244-2183
(904) 651-6049
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
017296700
FL
222Q00000X
Developmental Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017296700
—
FL
05
—
759172100
—
FL
Enumeration date
02/22/2007
Last updated
10/29/2018
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