Basic Information
| Provider Information | |||||||||
| NPI: | 1972220481 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | METZ | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | RMHCI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 677 ARTHUR MOORE DR | ||||||||
| Address2: | |||||||||
| City: | GREEN COVE SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 320439530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9046513597 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1542 KINGSLEY AVE STE 136-137 | ||||||||
| Address2: | |||||||||
| City: | ORANGE PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 320734586 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9044587780 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2022 | ||||||||
| LastUpdateDate: | 10/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | MHI22913 | FL | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.