Organization
MOSAIC PSYCHOLOGICAL AND WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRIN JOHN KIRKENDALL PH.D (CEO)
(904) 806-3070
Entity
Organization
Contact information
Practice address
200 MALAGA ST, SUITE 1, SAINT AUGUSTINE, FL 32084-3523
(904) 806-3070
Mailing address
1201 MACLAREN ST, SAINT AUGUSTINE, FL 32092-3431
(904) 806-3070
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
07/17/2014
Last updated
07/17/2014
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