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1003346115
ANTONIESHA AUSTIN
JACKSONVILLE, FL
NPI
1003346115
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
261QD1600X Clinic/Center, Developmental Disabilities
Enumeration Date
2017-06-13
Last Update Date
2017-06-13
Business Address
ANTONIESHA AUSTIN
8805 NORFOLK BLVD
JACKSONVILLE, FL 32208-1917
Phone number: 904-343-2218
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Mailing Address
ANTONIESHA AUSTIN
PO BOX 66054
JACKSONVILLE, FL 32208-6054
Phone number: 904-343-2218
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