Individual
RACQUEL DENISE WADDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
910 N JEFFERSON ST, JACKSONVILLE, FL 32209-6810
(904) 360-7022
Mailing address
910 N JEFFERSON ST, JACKSONVILLE, FL 32209-6810
(904) 360-7022
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
08/15/2013
Last updated
10/11/2018
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