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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