Individual
TIFFANY MIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2476 JUSTIN RD W, JACKSONVILLE, FL 32210-3453
(904) 258-6947
Mailing address
2476 JUSTIN RD W, JACKSONVILLE, FL 32210-3453
(904) 258-6947
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
10/07/2022
Last updated
10/07/2022
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