Lashaundra Dianne Bagmon Mciver
Marriage & Family Therapist in Jacksonville, FL. Individual provider (NPI-1).
NPI number1679212906
StatusActive
Last updated in NPPESJun 3, 2022
Details
- NPI
- 1679212906
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Lashaundra Dianne Bagmon Mciver
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 3, 2022
- Certification date
- Jun 3, 2022
- Last updated
- Jun 3, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | IMT3565 | FL | Yes |
Practice location
8540 Baycenter RdJacksonville, FL 32256-7420
Phone 904-448-1933
Mailing address
8540 Baycenter RdJacksonville, FL 32256-7420
Phone 904-448-1933
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