Provider Information for 1295487791
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JENNIFER ANN COULSON MA, LMHC
Sex: Female
NPI: 1295487791
Last Updated: 2024-05-15
Certification Date: 2024-05-15
Certification Date: 2024-05-15
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1295487791 | ||||||||
| Enumeration Date | 2022-01-25 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2392 EDGEWOOD AVE N JACKSONVILLE, FL 32254-1725 United States Phone: 904-781-7797 | Fax:904-781-8685 | ||||||||
| Primary Practice Address | 2392 EDGEWOOD AVE N JACKSONVILLE, FL 32254-1725 United States Phone: 904-781-7797 | Fax:904-781-8685 | ||||||||
| Secondary Practice Address(es) | 10245 CENTURION PKWY N STE 250 | ||||||||
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