Individual
TARYN CLINTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9063 GALLOWAY DR, JACKSONVILLE, FL 32219-4382
(904) 729-5667
Mailing address
9063 GALLOWAY DR, JACKSONVILLE, FL 32219-4382
(904) 729-5667
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013901200
—
FL
Enumeration date
03/30/2015
Last updated
03/30/2015
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