Individual
MRS. BERNADETTE EVELYENNA FIELDS I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
3606 JACOB LOIS DR, JACKSONVILLE, FL 32218-2970
(904) 612-1470
Mailing address
3606 JACOB LOIS DR, JACKSONVILLE, FL 32218-2970
(904) 612-1470
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
FL
222Q00000X
Developmental Therapist
—
FL
Other
Enumeration date
05/22/2015
Last updated
05/05/2016
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