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1952842528
PHYLLIS DIANE PORTER
JACKSONVILLE, FL
NPI
1952842528
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
251C00000X Day Training, Developmentally Disabled Services
(Licence: FL 000809200)
Enumeration Date
2017-03-16
Last Update Date
2017-03-16
Business Address
Miss PHYLLIS DIANE PORTER
6650 103RD ST APT 401
JACKSONVILLE, FL 32210-7143
Phone number: 904-559-5434
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Mailing Address
Miss PHYLLIS DIANE PORTER
PO BOX 7064
JACKSONVILLE, FL 32238-0064
Phone number: 904-444-3045
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