Individual
MARKEDIA LOUISE DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADP
Contact information
Practice address
2482 WYLENE ST, JACKSONVILLE, FL 32209-4576
(904) 966-9115
Mailing address
2482 WYLENE ST, JACKSONVILLE, FL 32209-4576
(904) 966-9115
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
09/09/2019
Last updated
09/09/2019
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