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General NPI Number Information
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NPI Number | 1639887128
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Entity Type | Organization
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Legal Business Name | I CHOOSE ME THERAPY SERVICES
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 11/14/2022
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Provider Practice Location Address
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Address Line | 926 BALKIN RD
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City | TALLAHASSEE
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State | FL
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Zip | 32305-3346
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Country | US
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Telephone | 850-404-9851
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Fax |
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Provider Business Mailing Address
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Address Line | 926 BALKIN RD
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City | TALLAHASSEE
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State | FL
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Zip | 32305-3346
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | KAYLA CHARISSE APRIL
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Credential | LCSW, CDP
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Telephone | 305-283-7306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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