Healthcare Provider Details

I. General information

NPI: 1497066344
Provider Name (Legal Business Name): DR. TOWNSEND & ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2010
Last Update Date: 06/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 SAINT JOHNS MEDICAL PK DR
ST AUGUSTINE FL
32086-5343
US

IV. Provider business mailing address

9 SAINT JOHNS MEDICAL PK DR
ST AUGUSTINE FL
32086-5343
US

V. Phone/Fax

Practice location:
  • Phone: 904-797-2705
  • Fax: 904-797-2820
Mailing address:
  • Phone: 904-797-2705
  • Fax: 904-797-2820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. VANESSA TOWNSEND
Title or Position: OWNER
Credential: PSY.D.
Phone: 904-797-2705