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Individual

ANDREA GOLLEGLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1673 MASON AVE, DAYTONA BEACH, FL 32117-5515
(386) 944-7813
(386) 252-3403
Mailing address
1219 DUNN AVE, DAYTONA BEACH, FL 32114-2405
(386) 944-7813
(386) 252-3403

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000000000
FL
Enumeration date
06/12/2019
Last updated
06/12/2019
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