Individual
MS. KIMYATA MARIE WHALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A
Contact information
Practice address
623 BEECHWOOD ST, JACKSONVILLE, FL 32206-6236
(904) 358-1211
(904) 854-6553
Mailing address
11735 CHERRY BARK DR E, JACKSONVILLE, FL 32218-7677
(904) 358-1211
(904) 854-6553
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/24/2012
Last updated
02/24/2012
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