Individual
CLARISSA BERTHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1225 W BEAVER ST, JACKSONVILLE, FL 32204-1414
(904) 412-4009
Mailing address
9336 THUNDERBOLT DR, JACKSONVILLE, FL 32221-8023
(904) 412-4009
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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