Provider Demographics
NPI:1124354899
Name:HELLAMS, EMILY ROSE (MSW)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:ROSE
Last Name:HELLAMS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4570 SAINT JOHNS AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-1848
Mailing Address - Country:US
Mailing Address - Phone:904-389-5231
Mailing Address - Fax:904-389-7067
Practice Address - Street 1:4570 SAINT JOHNS AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-1848
Practice Address - Country:US
Practice Address - Phone:904-389-5231
Practice Address - Fax:904-389-7067
Is Sole Proprietor?:No
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker