Mary Imhansiemhonehi

NPI #1235786856 in Jacksonville, Florida

Provider Information

NPI Number: 1235786856
Entity Type: Individual
Name: Mary Imhansiemhonehi
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Aug 19, 2019
Last Updated: Aug 19, 2019

Practice Location

Address: 4568 ANTLER HILL DR E
City: Jacksonville
State: Florida
ZIP Code: 32224-8704
Phone: (386) 265-8778

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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