Individual
JILL MARLENE NANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2475 GARRISON AVE, PORT ST JOE, FL 32456-5265
(850) 227-1276
(850) 227-1497
Mailing address
2475 GARRISON AVE, PORT ST JOE, FL 32456-5265
(850) 227-1276
(850) 227-1497
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW 9733
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000
HAS NOT BEEN ISSUED ANY NUMBERS
—
Enumeration date
08/28/2008
Last updated
01/26/2010
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