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General NPI Number Information
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NPI Number | 1861776882
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Entity Type | Individual
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Provider Name | MARGARET JO TEMPLE MH 13408
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Gender | Female
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Dates
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Enumeration Date | 10/10/2011
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Last Update Date | 07/11/2016
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Provider Practice Location Address
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Address Line | 1500 GANO AVE
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City | ORANGE PARK
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State | FL
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Zip | 32073-4506
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Country | US
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Telephone | 904-450-5132
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Fax |
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Provider Business Mailing Address
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Address Line | 7068 DEER LODGE CIR UNIT 105
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City | JACKSONVILLE
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State | FL
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Zip | 32256-8570
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Country | US
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Telephone | 904-450-5132
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MH 13408
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License Number State | FL
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