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Organization
COUNSELING INC., DBA ALLIANCE COUNSELING
Active
Organization
COUNSELING INC., DBA ALLIANCE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNA HICKENBOTHAM LMHC (MENTAL HEALTH COUNSELOR)
(850) 226-7226
Entity
Organization
Contact information
Practice address
17 RACETRACK RD NW, FORT WALTON BEACH, FL 32547-4616
(850) 226-6828
Mailing address
17 RACETRACK RD NW, FORT WALTON BEACH, FL 32547-4616
(850) 226-6828
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH11935
FL
Other
Enumeration date
03/19/2015
Last updated
03/19/2015
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