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General NPI Number Information
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NPI Number | 1699879080
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Entity Type | Individual
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Provider Name | BARBARA ANN MAXWELL LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2003B WILSON AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4532
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Country | US
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Telephone | 850-215-8552
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Fax | 850-215-8551
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Provider Business Mailing Address
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Address Line | 315 LANDINGS DR
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City | LYNN HAVEN
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State | FL
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Zip | 32444-3242
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Country | US
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Telephone | 850-271-5491
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Fax | 850-215-8551
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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 | SW4097
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License Number State | FL
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