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1588760250
JACK MORTON
MELBOURNE, FL
NPI
1588760250
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: FL MH00004351)
Enumeration Date
2006-09-16
Last Update Date
2007-07-08
Business Address
-- JACK MORTON LMHC
1800 PENN ST STE 12
MELBOURNE, FL 32901-2625
Phone number: 321-768-6800
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Mailing Address
-- JACK MORTON LMHC
736 ESPANOLA WAY
MELBOURNE, FL 32901-4140
Phone number: 321-724-9636
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