Individual
AMANDA BLEAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4203 SOUTHPOINT BLVD, JACKSONVILLE, FL 32216-6164
(904) 296-1055
(904) 296-1953
Mailing address
4203 SOUTHPOINT BLVD, JACKSONVILLE, FL 32216-6164
(904) 296-1055
(904) 296-1953
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH11952
FL
Other
Enumeration date
08/06/2013
Last updated
08/06/2013
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