| Doctor Name: | MISS CAROL ANN VISCONTI |
| NPI Number: | 1285868141 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1747 Baptist Clay Dr Suite 350 Fleming Island, FL - 320038502 |
| Business Phone Number: | 9043763800 |
| Business Fax Number: | 9043968966 |
| Mailing Address: | 4160 University Blvd S, JACKSONVILLE |
| State: | FL |
| Postal Code: | 322164317 |
| Phone Number: | 9043763800 |
| Fax Number: | 9043968966 |
| NPI Enumeration Date: | 05/07/2009 |
| NPI Last Update Date: | 09/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |