Individual
TIFFANY WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5991 CHESTER AVE, SUITE 211, JACKSONVILLE, FL 32217
(904) 566-0200
Mailing address
5991 CHESTER AVE, SUITE 211, JACKSONVILLE, FL 32217-2269
(904) 566-0200
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
—
—
1041S0200X
School Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/22/2015
Last updated
08/08/2018
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