Individual
DANIEL PRIDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
379 TIDEWATER DR, JACKSONVILLE, FL 32211-7226
(904) 210-6666
Mailing address
379 TIDEWATER DR, JACKSONVILLE, FL 32211-7226
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IMH28776
FL
Other
Enumeration date
06/06/2026
Last updated
06/06/2026
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