Organization
ETTA ETTLINGER, LCSW, PA
Active
Organization
ETTA ETTLINGER, LCSW, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ETTA F. ETTLINGER LCSW (CLINICAL SOCIAL WORKER)
(904) 273-4099
Entity
Organization
Contact information
Practice address
100 EXECUTIVE WAY STE 110, PONTE VEDRA, FL 32082-4753
(904) 273-4099
(904) 273-4095
Mailing address
100 EXECUTIVE WAY STE 110, PONTE VEDRA, FL 32082-4753
(904) 273-4099
(904) 273-4095
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW6310
FL
Other
Enumeration date
01/03/2008
Last updated
01/03/2008
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