Individual
MR. MICHAEL BRENT WADE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
4711 US HIGHWAY 17, BLDG C SUITE 4, FLEMING ISLAND, FL 32003-8233
(904) 465-1275
Mailing address
308 MARISCO WAY, JACKSONVILLE, FL 32220-4608
(904) 465-1275
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
MH 11491
FL
Other
Enumeration date
08/02/2010
Last updated
08/13/2015
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