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Individual

MRS. STEPHANIE R FORDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
12379 GLIMMER WAY, JACKSONVILLE, FL 32219-1867
(904) 314-7411
(904) 751-2200
Mailing address
12379 GLIMMER WAY, JACKSONVILLE, FL 32219-1867
(904) 314-7411
(904) 751-2200

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
374U00000X
Home Health Aide
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
06/18/2019
Last updated
11/27/2023
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