Organization
SANTA ROSA COUNTY SCHOOL BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODERICK C. GRACEY (DIRECTOR STUDENT SERVICES)
(850) 983-5587
Entity
Organization
Contact information
Practice address
6751 BERRYHILL ST, MILTON, FL 32570-4790
(850) 983-5151
(850) 983-5577
Mailing address
6751 BERRYHILL ST, MILTON, FL 32570-4790
(850) 983-5151
(850) 983-5577
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081005317
—
FL
Enumeration date
12/12/2006
Last updated
01/29/2009
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