Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | SW 7412 | FL |
NPI | 1003252594 |
---|---|
Provider Name | Mr. Daniel J Button |
First Address | Jacksonville Beach, FL 32250-7219 |
Second Address | Jacksonville Beach, FL 32250-7219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2013 |
Last Update Date | 12/01/2016 |