Individual
MRS. JONNATHAN ALBERTO ESTRADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
19228 NW US HIGHWAY 441, HIGH SPRINGS, FL 32643-8783
(386) 454-1156
Mailing address
19228 NW US HIGHWAY 441, HIGH SPRINGS, FL 32643-8783
(386) 454-1156
(352) 373-4455
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
FL
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
06/24/2011
Last updated
09/08/2020
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