Organization
KOINONIA DYNAMISINC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ADDRIS B VINSON LMHC.CRC (CEO)
(904) 536-4371
Entity
Organization
Contact information
Practice address
2979 CENTERWOOD DR, JACKSONVILLE, FL 32218-9208
(904) 536-4371
Mailing address
2979 CENTERWOOD DR, JACKSONVILLE, FL 32218-9208
(904) 536-4371
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MH90
FL
Other
Enumeration date
05/19/2016
Last updated
05/19/2016
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