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1720649627
JACOB A WIDDEKIND
HOLLYWOOD, FL
NPI
1720649627
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: FL MH17127)
Enumeration Date
2019-06-22
Last Update Date
2019-06-22
Business Address
Mr. JACOB A WIDDEKIND MS
2421 HOLLYWOOD BLVD STE 1A
HOLLYWOOD, FL 33020-6605
Phone number: 954-369-0570
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Mailing Address
Mr. JACOB A WIDDEKIND MS
2421 HOLLYWOOD BLVD STE 1A
HOLLYWOOD, FL 33020-6605
Phone number: 954-369-0570
Copy
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