Individual
NATASHA MCKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1084 JONES CREEK DR, JACKSONVILLE, FL 32225-6303
(904) 993-6696
Mailing address
1084 JONES CREEK DR, JACKSONVILLE, FL 32225-6303
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
767149100
—
FL
Enumeration date
01/08/2007
Last updated
07/15/2013
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