Provider Information for 1831348002
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Ms. RHONDA K. MYRICK ACSW, LCSW
Sex: Female
NPI: 1831348002
Last Updated: 2019-08-21
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1831348002 | ||||||||
| Enumeration Date | 2008-09-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 255 OLD VILLAGE CENTER CIR UNIT #9106 ST AUGUSTINE, FL 32084-5803 United States Phone: 904-687-4420 | Fax: | ||||||||
| Primary Practice Address | 11120 S CROWN WAY STE 1 WELLINGTON, FL 33414-8718 United States Phone: 561-790-1191 | Fax: | ||||||||
| Secondary Practice Address(es) | 255 OLD VILLAGE CENTER CIR | ||||||||
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