| Theralogy, Llc | |
|
4300 Marsh Landing Blvd Suite 204 Jacksonville Beach FL 32250 | |
| (904) 515-2050 | |
| Not Available |
| Full Name | Theralogy, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 4300 Marsh Landing Blvd, Jacksonville Beach, Florida |
| Authorized Official Name and Position | Christine Ellis (MGR) |
| Authorized Official Contact | 9045152370 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theralogy, Llc 1015 Atlantic Blvd Ste 161 Atlantic Beach FL 32233-3313 Ph: (904) 515-2370 | Theralogy, Llc 4300 Marsh Landing Blvd Suite 204 Jacksonville Beach FL 32250 Ph: (904) 515-2050 |
| NPI Number | 1154918209 |
|---|---|
| Provider Enumeration Date | 12/23/2020 |
| Last Update Date | 12/23/2020 |
| Certification Date | 12/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154918209 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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