Bollingmo, Justin Tyler

Bollingmo, Justin Tyler is an sole proprietor health care provider with primary practice located at 1650 Prudential Dr Ste 210 , Jacksonville FL 32207-8149. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Bollingmo, Justin Tyler can be contacted via phone (904) 376-3800.

Contact Information

Primary practice address
1650 Prudential Dr Ste 210 Jacksonville FL 32207-8149
Phone: (904) 376-3800
Fax: (904) 396-4942
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 3292 Florida

Profile Details

NPI number 1326436981
LBN Legal business name Bollingmo, Justin Tyler
Credentials LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 6th, 2015
Last updated May 13th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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