Provider Demographics
NPI:1629664016
Name:MCBRIDE, JAWANDA
Entity Type:Individual
Prefix:MISS
First Name:JAWANDA
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3832 SUTTON PLACE BLVD APT 1024
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-6797
Mailing Address - Country:US
Mailing Address - Phone:407-676-8970
Mailing Address - Fax:
Practice Address - Street 1:3832 SUTTON PLACE BLVD APT 1024
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-6797
Practice Address - Country:US
Practice Address - Phone:407-676-8970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor