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Organization
RESOLUTION TODAY
Active
Organization
RESOLUTION TODAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RACHEL HASKELL (OWNER)
(727) 698-2543
Entity
Organization
Contact information
Practice address
1700 PARK ST N STE 109, ST PETERSBURG, FL 33710-4300
(727) 698-2543
Mailing address
6177 SUN BLVD APT 404, ST PETERSBURG, FL 33715-1146
(727) 698-2543
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101273400
—
FL
Enumeration date
10/24/2019
Last updated
10/24/2019
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