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NPI Code Detail

MEDICARE: JANET D. CONSTANTINE PL

MEDICARE: JANET D. CONSTANTINE PL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/CenterMH 3146FL

General Provider Information

NPI Number : 1124441175
Entity Type Code : Organization
Provider Name (Legal Business Name) : JANET D. CONSTANTINE PL
Provider Business Mailing Address
First Line : 9822 TAPESTRY PARK CIR
Second Line : SUITE 206
City : JACKSONVILLE
State : FL
Zip : 32246-9258
Country : US
Telephone Number : 904-637-1708
Fax Number : 904-207-7897
Provider Business Practice Location Address
First Line : 9822 TAPESTRY PARK CIR
Second Line : SUITE 206
City : JACKSONVILLE
State : FL
Zip : 32246-9258
Country : US
Telephone Number : 904-637-1708
Fax Number : 904-207-7897
Authorized Official
Title or Position : PRESIDENT
Name : JANET DIANNE CONSTANTINE
Credential : LMHC CET II
Telephone Number : 904-637-1708
Provider Enumeration Date : 01/28/2014
Last Update Date : 01/28/2014

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