Individual
MS. REGINA MICHELLE MAYWEATHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. M.F.T.
Contact information
Practice address
2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
(904) 781-0600
Mailing address
PO BOX 1631, JACKSONVILLE, FL 32201-1631
(904) 742-9883
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
IMT 2310
FL
Other
Enumeration date
08/16/2016
Last updated
08/16/2016
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