Individual
MR. STEVEN JERROLD WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED
Contact information
Practice address
1111 12TH STREET, SUITE 204, KEY WEST, FL 33040-3011
(305) 747-2124
(305) 293-4339
Mailing address
1111 12TH STREET, SUITE 204, KEY WEST, FL 33040-3011
(305) 747-2124
(305) 293-4339
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
MHC 6306
FL
106H00000X
Marriage & Family Therapist
Primary
MFT 2056
FL
Other
Enumeration date
08/25/2006
Last updated
07/16/2015
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