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General NPI Number Information
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NPI Number | 1679004162
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Entity Type | Organization
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Legal Business Name | CLEAR RESOLUTIONS, LLC
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Dates
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Enumeration Date | 03/25/2017
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Last Update Date | 03/25/2017
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Provider Practice Location Address
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Address Line | 3653 CAGNEY DR STE 204
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City | TALLAHASSEE
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State | FL
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Zip | 32309-3353
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Country | US
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Telephone | 727-403-9550
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 180563
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City | TALLAHASSEE
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State | FL
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Zip | 32318-0006
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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 | LICENSED CLINICAL SOCIAL WORKER
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Name | TAMARA KNIBBS
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Credential | LCSW
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Telephone | 727-403-9550
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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 | SW11277
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License Number State | FL
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