Individual
ANNQUENETTE C DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6859 LENOX AVE STE 32, JACKSONVILLE, FL 32205-6149
(904) 405-2631
Mailing address
6859 LENOX AVE STE 32, JACKSONVILLE, FL 32205-6149
(904) 405-2631
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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