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General NPI Number Information
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NPI Number | 1770967853
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Entity Type | Organization
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Legal Business Name | DSM PROBLEM SOLVING AND LIFE SKILLS
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | 219 ALLEN AVE
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City | PANAMA CITY
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State | FL
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Zip | 32401-3288
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Country | US
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Telephone | 850-624-5903
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Fax | 850-785-3614
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Provider Business Mailing Address
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Address Line | 219 ALLEN AVE
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City | PANAMA CITY
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State | FL
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Zip | 32401-3288
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Country | US
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Telephone | 850-624-5903
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Fax | 850-785-3614
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DIANE S MARSHALL
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Credential | LMHC
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Telephone | 850-624-5903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH10148
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License Number State | FL
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