Individual
ASZLOYN NIKITA WAKEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.S.
Contact information
Practice address
12280 SUMTER SQUARE DR W, JACKSONVILLE, FL 32218-6125
(904) 622-8684
(904) 765-0011
Mailing address
12280 SUMTER SQUARE DR W, JACKSONVILLE, FL 32218-6125
(904) 622-8684
(904) 765-0011
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/16/2016
Last updated
07/02/2020
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