Individual
JACQUELINE SUE COLUNGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5128 27TH AVE S, GULFPORT, FL 33707-5414
(727) 327-9046
Mailing address
5128 27TH AVE S, GULFPORT, FL 33707-5414
(727) 327-9046
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
SW8486
FL
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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