Provider Demographics
NPI:1720360449
Name:WEBBER, JANICE M
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:M
Last Name:WEBBER
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 1:2715 OAK ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-8204
Mailing Address - Country:US
Mailing Address - Phone:904-356-1612
Mailing Address - Fax:904-356-7095
Practice Address - Street 1:2715 OAK ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-8204
Practice Address - Country:US
Practice Address - Phone:904-356-1612
Practice Address - Fax:904-356-7095
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management