Provider Information for 1619351285
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ELAINE WELLS Social Worker
Sex: Female
NPI: 1619351285
Last Updated: 2023-08-11
Certification Date: 2023-08-11
Certification Date: 2023-08-11
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1619351285 | ||||||||||||||
| Enumeration Date | 2015-07-14 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | NS MAYPORT, 2104 MASSEY AVE JACKSONVILLE, FL 32228 United States Phone: 904-270-4340 | Fax: | ||||||||||||||
| Primary Practice Address | 10744 GRAYSON CT JACKSONVILLE, FL 32220-1894 United States Phone: 904-386-0943 | Fax: | ||||||||||||||
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