Individual
LACENDIA MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11036 LYDIA ESTATES DR W, JACKSONVILLE, FL 32218-6937
(904) 305-1608
Mailing address
11036 LYDIA ESTATES DR W, JACKSONVILLE, FL 32218-6937
(904) 305-1608
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
FL
Other
Enumeration date
04/02/2018
Last updated
04/02/2018
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