Individual
TERRI DENISE STATEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
(904) 781-7797
Mailing address
2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
(904) 554-6637
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/30/2019
Last updated
04/30/2019
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