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1544 Ruskin Ln Fernandina Beach FL 32034-1958 | |
| (904) 405-9469 | |
| (855) 261-3372 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1544 Ruskin Ln, Fernandina Beach, Florida |
| Authorized Official Name and Position | Lori Beard (OWNER/PRESIDENT) |
| Authorized Official Contact | 9044059469 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1544 Ruskin Ln Fernandina Beach FL 32034-1958 Ph: (904) 405-9469 | 1544 Ruskin Ln Fernandina Beach FL 32034-1958 Ph: (904) 405-9469 |
| NPI Number | 1497129639 |
|---|---|
| Provider Enumeration Date | 11/28/2015 |
| Last Update Date | 11/28/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497129639 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH11799 (Florida) | Primary |
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