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Organization
INNOVATIVE DIRECTION
Active
Organization
INNOVATIVE DIRECTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALYSSA WARREN MS, LMHC (OWNER/PRACTICIING CLINICIAN)
(850) 583-1342
Entity
Organization
Contact information
Practice address
5101 N 12TH AVE, PENSACOLA, FL 32504-8928
(850) 583-1342
(850) 665-0132
Mailing address
5101 N 12TH AVE, PENSACOLA, FL 32504-8928
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH14671
FL
Other
Enumeration date
09/11/2017
Last updated
09/11/2017
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