| Jacqueline M Rita, Lmhc, Llc | |
|
211 E International Speedway Blvd Ste 107 Daytona Beach FL 32118-4662 | |
| (401) 486-6081 | |
| (386) 401-2414 |
| Full Name | Jacqueline M Rita, Lmhc, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 211 E International Speedway Blvd Ste 107, Daytona Beach, Florida |
| Authorized Official Name and Position | Jacqueline M Rita (OWNER/PROVIDER) |
| Authorized Official Contact | 4014866081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacqueline M Rita, Lmhc, Llc 1225 Ruthbern Rd Daytona Beach FL 32114-5961 Ph: (401) 486-6081 | Jacqueline M Rita, Lmhc, Llc 211 E International Speedway Blvd Ste 107 Daytona Beach FL 32118-4662 Ph: (401) 486-6081 |
| NPI Number | 1356137699 |
|---|---|
| Provider Enumeration Date | 04/15/2025 |
| Last Update Date | 04/15/2025 |
| Certification Date | 04/15/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356137699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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