Provider First Line Business Practice Location Address:
1 UNF DRIVE
Provider Second Line Business Practice Location Address:
C/O RICHMOND WYNN DEPT. OF CLINICAL MENTAL HEALTH COUNS
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-221-8632
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/13/2012