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MRS. JESSICA LAND
>> Case Manager/Care Coordinator >> Other Service ProvidersRegistrant NPI Number: 1528566353
Individual Registrant:MRS. JESSICA LAND
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
653 SW CHOCTAW AVE FORT WHITE, FL 32038 US
Tel: 386-623-3000 Fax: --
Tel: 386-623-3000 Fax: --
Contact information for business:
653 SW CHOCTAW AVE FORT WHITE, FL 32038 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1528566353
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 171M00000X | Other Service Providers Case Manager/Care Coordinator | ||
| N | 175F00000X | Other Service Providers Naturopath | ||
| N | 225C00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Rehabilitation Counselor | ||
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 022880200 | FL | 05 |
