| Wildly Authentic Counseling, Llc | |
|
12443 San Jose Blvd Ste 202 Jacksonville FL 32223-8648 | |
| (904) 337-9040 | |
| Not Available |
| Full Name | Wildly Authentic Counseling, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 12443 San Jose Blvd Ste 202, Jacksonville, Florida |
| Authorized Official Name and Position | Amy Kristine Schaet (OWNER) |
| Authorized Official Contact | 9048858278 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wildly Authentic Counseling, Llc 630 Kingsley Ave Orange Park FL 32073-5465 Ph: (904) 885-8278 | Wildly Authentic Counseling, Llc 12443 San Jose Blvd Ste 202 Jacksonville FL 32223-8648 Ph: (904) 337-9040 |
| NPI Number | 1053086793 |
|---|---|
| Provider Enumeration Date | 08/13/2021 |
| Last Update Date | 06/25/2024 |
| Certification Date | 06/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053086793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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