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General NPI Number Information
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NPI Number | 1114839586
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Entity Type | Individual
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Provider Name | MINDY WEYNAND RICSW
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Gender | Female
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Dates
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Enumeration Date | 09/21/2026
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Last Update Date | 09/21/2026
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Provider Practice Location Address
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Address Line | 2687 JENKS AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4351
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Country | US
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Telephone | 706-691-9105
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Fax |
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Provider Business Mailing Address
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Address Line | 270 LAWTON BRANCH WAY
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City | CALLAWAY
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State | FL
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Zip | 32404-2276
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Country | US
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Telephone | 706-691-9105
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ISW22997
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License Number State | FL
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