Mrs. Tracy A. Bohannon M.E.D
Mental Health Counselor in Jacksonville, FL(View on Map)
Full Name
Mrs. Tracy Aidan Bohannon M.E.D
NPI Number
1023207453
NPI Type
Individual Provider
Gender
Female
Enumeration Date
10/22/2007
Specialties
(Taxonomies)Licenses
State
Florida
License Number
MH23300
Contact
Information
Purpose
Mailing
Location
Address
11461 CONN RD
4720 SALISBURY RD
City
Jacksonville
Jacksonville
State
FL
FL
Postal Code
32218-2167
32256-6101
Country
US
US
Telephone Number
(904) 858-1963
(904) 206-8405
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 09/14/2024