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31 W Adams St Apt 608 Jacksonville FL 32202-3631 | |
| (704) 277-1884 | |
| (904) 289-2672 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 31 W Adams St Apt 608, Jacksonville, Florida |
| Authorized Official Name and Position | Crystal Sharee Thompson (OWNER/DIRECTOR) |
| Authorized Official Contact | 7042771884 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
31 W Adams St Apt 608 Jacksonville FL 32202-3631 Ph: (704) 277-1884 | 31 W Adams St Apt 608 Jacksonville FL 32202-3631 Ph: (704) 277-1884 |
| NPI Number | 1518322577 |
|---|---|
| Provider Enumeration Date | 12/17/2015 |
| Last Update Date | 07/15/2020 |
| Certification Date | 07/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518322577 | NPI | - | NPPES |
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