Most Relevant Information
Provider Data
| NPI Number: | 1003514936 |
| Provider Name: | KALLYN RICHARDSON |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | SW20839 |
Most Important Dates
| Enumeration Date: | 02/20/2023 |
| Last Updated: | 02/20/2023 |
Provider Practice Location
11478 HARLAN DR
JACKSONVILLE
FL
322184052
Practice Location Phone/Fax
| Phone: | 7348340459 |
| Fax: |
Provider Mailing Location
11478 HARLAN DR
JACKSONVILLE
FL
322184052
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |