Provider Demographics
NPI:1639848302
Name:WARD, LOUVONIA JULIA (PHD)
Entity Type:Individual
Prefix:
First Name:LOUVONIA
Middle Name:JULIA
Last Name:WARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8367 CANDLEWOOD COVE TRL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-8901
Mailing Address - Country:US
Mailing Address - Phone:850-294-8489
Mailing Address - Fax:
Practice Address - Street 1:1601 PARK CENTER DR STE 12
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-5700
Practice Address - Country:US
Practice Address - Phone:407-701-5271
Practice Address - Fax:407-209-0329
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS1299103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool