Healthcare Provider Details
I. General information
NPI: 1982959177
Provider Name (Legal Business Name): RITA G BALDWIN BA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/13/2012
Last Update Date: 07/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
717 SW MLK JR AVE
OCALA FL
34471-1435
US
IV. Provider business mailing address
5664 SW 60TH AVE
OCALA FL
34474-5677
US
V. Phone/Fax
- Phone: 352-236-8300
- Fax: 352-236-8390
- Phone: 352-291-5555
- Fax: 352-291-9536
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: