Individual
MYA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
910 N JEFFERSON ST, JACKSONVILLE, FL 32209-6810
(904) 360-7022
Mailing address
910 N JEFFERSON ST, JACKSONVILLE, FL 32209-6810
(904) 360-7022
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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