Individual
MRS. SANDRA LEE BIRCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
313 BROOKCHASE LN W, JACKSONVILLE, FL 32225-6215
(904) 476-9298
Mailing address
313 BROOKCHASE LN W, JACKSONVILLE, FL 32225-6215
(904) 476-9298
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
EIN 43-208618
FL
Other
Enumeration date
03/13/2012
Last updated
03/13/2012
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