Organization
SANKOFA BEHAVIORAL HEALTH SERVICES LLC
Active
Organization
SANKOFA BEHAVIORAL HEALTH SERVICES LLC
Active
Other names
Dr. Mia R. Wilson
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIA R WILSON ED.D (LMHC)
(904) 891-6614
Entity
Organization
Contact information
Practice address
5379 LENOX AVE, JACKSONVILLE, FL 32205-4737
(904) 891-6614
(904) 512-6614
Mailing address
PO BOX 8056, JACKSONVILLE, FL 32239-0056
(904) 891-6614
(904) 512-6614
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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