Provider Information for 1407126998
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Mr. LLOYD ERNEST DAHLEN II LCSW
Sex: Male
NPI: 1407126998
Last Updated: 2018-03-16
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1407126998 | ||||||||||||
| Enumeration Date | 2011-12-30 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 4205 BELFORT RD STE 4015 JACKSONVILLE, FL 32216-3623 United States Phone: 904-450-8900 | Fax: | ||||||||||||
| Primary Practice Address | 7751 BAYMEADOWS RD E STE G JACKSONVILLE, FL 32256-5836 United States Phone: 904-450-8900 | Fax:904-450-8938 | ||||||||||||
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