Individual
MRS. JEANNINE BOYLE MIELKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3 SHIRCLIFF WAY, SUITE #333, JACKSONVILLE, FL 32204-4757
(904) 607-2079
(904) 384-0094
Mailing address
7177 AUGUSTA DR, FLEMING ISLAND, FL 32003-8755
(904) 529-7441
(904) 529-7440
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY0006839
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74187
BCBSF
FL
Enumeration date
01/05/2007
Last updated
08/01/2008
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