Most Relevant Information
Provider Data
| NPI Number: | 1003423310 |
| Provider Name: | KAYLEE MCCALLAN |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | MH18405 |
Most Important Dates
| Enumeration Date: | 09/30/2020 |
| Last Updated: | 09/30/2020 |
Provider Practice Location
390 16TH AVE S
JACKSONVILLE BEACH
FL
322504961
Practice Location Phone/Fax
| Phone: | 9043953899 |
| Fax: |
Provider Mailing Location
390 16TH AVE S
JACKSONVILLE BEACH
FL
322504961
Provider Mailing Phone/Fax
| Phone: | 9043953899 |
| Fax: |