Individual
ANTWAN NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1225 W BEAVER ST STE 205, JACKSONVILLE, FL 32204-1416
(904) 712-3540
(904) 775-3570
Mailing address
1225 W BEAVER ST STE 205, JACKSONVILLE, FL 32204-1416
(904) 712-3540
(904) 775-3570
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/21/2019
Last updated
03/21/2019
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