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General NPI Number Information
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NPI Number | 1518653526
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Entity Type | Individual
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Provider Name | MASHELL THOMAS RMHI, MSCP
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Gender | Female
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 7855 ARGYLE FOREST BLVD STE 703
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City | JACKSONVILLE
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State | FL
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Zip | 32244-7705
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Country | US
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Telephone | 904-263-5055
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Fax | 904-801-8994
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Provider Business Mailing Address
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Address Line | 3806 BRONCO RD
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City | MIDDLEBURG
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State | FL
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Zip | 32068-8820
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Country | US
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Telephone | 808-392-3960
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 20257
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License Number State | FL
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