Organization
EXIT 56 THERAPY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIELLE GRIFFITH (PRESIDENT)
(850) 634-6020
Entity
Organization
Contact information
Practice address
124 JOHN KING RD, CRESTVIEW, FL 32539-8306
(850) 634-6020
(850) 680-6289
Mailing address
124 JOHN KING RD, CRESTVIEW, FL 32539-8306
(850) 634-6020
(850) 680-6289
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
103TS0200X
School Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
224Z00000X
Occupational Therapy Assistant
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/27/2024
Last updated
11/27/2024
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