Mack, Elizabeth

Mack, Elizabeth is an sole proprietor health care provider with primary practice located at 7929 Eaton Ave , Jacksonville FL 32211-7848. She recently has only one registered license in Behavioral Health & Social Service Providers / Assistant Behavior Analyst, which is considered as her primary health care specialty. Mack, Elizabeth can be contacted via phone (904) 420-2304.

Contact Information

Primary practice address
7929 Eaton Ave Jacksonville FL 32211-7848
Phone: (904) 420-2304
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Assistant Behavior Analyst 106E00000X Florida

Profile Details

NPI number 1699319210
LBN Legal business name Mack, Elizabeth
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 6th, 2019
Last updated Nov 6th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699319210 NPPES
Florida MEDICAID 17113

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