Most Relevant Information
Provider Data
| NPI Number: | 1003301441 |
| Provider Name: | CASEY NEIDIG |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/28/2018 |
| Last Updated: | 06/28/2018 |
Provider Practice Location
590 ELLIS RD S BLDG 4
JACKSONVILLE
FL
322543555
Practice Location Phone/Fax
| Phone: | 9048002231 |
| Fax: |
Provider Mailing Location
590 ELLIS RD S BLDG 4
JACKSONVILLE
FL
322543555
Provider Mailing Phone/Fax
| Phone: | 9048002231 |
| Fax: |