Individual
DR. MARY BOYD NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., LMFT
Contact information
Practice address
320 HIGH TIDE DR, SUITE 101, ST AUGUSTINE, FL 32080-2323
(904) 392-1704
(904) 460-0068
Mailing address
320 HIGH TIDE DR, SUITE 101, ST AUGUSTINE, FL 32080-2323
(904) 392-1704
(904) 460-0068
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT2223
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
510603971
FEIN
FL
Enumeration date
05/22/2007
Last updated
03/25/2009
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