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Organization
SOUTHERN ROOTS PSYCHIATRY INC
Active
Organization
SOUTHERN ROOTS PSYCHIATRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ETHEL SIZEMORE CRNP, PMHNP-BC (OWNER / PMHNP-BC)
(850) 693-4171
Entity
Organization
Contact information
Practice address
4469 CLINTON ST STE B, MARIANNA, FL 32446-3453
(850) 693-4171
(850) 303-6006
Mailing address
90 SOUTHERN OAK DR, DOTHAN, AL 36301-7643
(850) 658-2569
(850) 303-6006
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/14/2025
Last updated
09/09/2026
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