Individual
ELLE MARRIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3725 BELFORT RD, JACKSONVILLE, FL 32216-5813
(904) 296-1055
(904) 448-7700
Mailing address
3725 BELFORT RD, JACKSONVILLE, FL 32216-5813
(904) 296-1055
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
SW 13582
FL
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PEND
—
FL
Enumeration date
07/07/2016
Last updated
07/18/2016
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