Individual
CHARLENE VANDIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3361 SARA DR, JACKSONVILLE, FL 32277-2525
(904) 742-0826
Mailing address
6999-02 MERRILL RD, #206, JACKSONVILLE, FL 32277-2525
(904) 742-0826
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
9222
FL
1041C0700X
Clinical Social Worker
Primary
SW15684
FL
Other
Enumeration date
03/27/2015
Last updated
07/29/2022
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