Individual
ALLISON THARALDSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1726 KINGSLEY AVE, ORANGE PARK, FL 32073-4463
(904) 291-5561
Mailing address
1726 KINGSLEY AVE STE 2, ORANGE PARK, FL 32073-4411
(904) 291-5561
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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