Individual
MRS. LASHAUNDRA DIANNE BAGMON MCIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8540 BAYCENTER RD, JACKSONVILLE, FL 32256-7420
(904) 448-1933
Mailing address
8540 BAYCENTER RD, JACKSONVILLE, FL 32256-7420
(904) 448-1933
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
IMT3565
FL
Other
Enumeration date
06/03/2022
Last updated
06/03/2022
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