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Contact Information

HOLLY M ANTAL, PHD
807 CHILDRENS WAY
JACKSONVILLE, FL32207-8426
 Phone: 904-390-3785
 Fax: 904-390-3512
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for HOLLY M ANTAL · (Female)

NPI Number 1336150853
Status Active
Credentials PHD
Entity Individual
Enumeration date 08/10/2006
Last updated 09/02/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • FL License # PY7214
  • GA Medicaid 332357411A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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