| J Nicholas Prewett Phd & Associates Pa | |
|
1726 Kingsley Ave Suite 12 Orange Park FL 32073-4463 | |
| (904) 269-6071 | |
| (904) 269-6642 |
| Full Name | J Nicholas Prewett Phd & Associates Pa |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1726 Kingsley Ave, Orange Park, Florida |
| Authorized Official Name and Position | Johann Nicholas Prewett (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 9042696071 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J Nicholas Prewett Phd & Associates Pa 1726 Kingsley Ave Suite 12 Orange Park FL 32073-4463 Ph: (904) 269-6071 | J Nicholas Prewett Phd & Associates Pa 1726 Kingsley Ave Suite 12 Orange Park FL 32073-4463 Ph: (904) 269-6071 |
| NPI Number | 1134276140 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 03/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134276140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH6231 (Florida) | Secondary |
| 103TC0700X | Psychologist - Clinical | PY4331 (Florida) | Primary |
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