Individual
MRS. HEATHER RICE CORNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4250 LAKESIDE DR, SUITE 116 AGING TRUE/URBAN JACKSONVILLE, JACKSONVILLE, FL 32210-3358
(904) 807-1291
(904) 807-1220
Mailing address
4250 LAKESIDE DR, SUITE 116 AGING TRUE/URBAN JACKSONVILLE, JACKSONVILLE, FL 32210-3358
(904) 807-1291
(904) 807-1220
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
766879100
—
FL
Enumeration date
10/26/2006
Last updated
10/02/2013
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