Individual
NIAKEASHA BURNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2711 W 15TH ST, PANAMA CITY, FL 32401-1366
(850) 769-6001
Mailing address
2138 S ATLANTA ST, QUINCY, FL 32351-8656
(850) 363-7411
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
686825898
—
FL
Enumeration date
10/16/2013
Last updated
10/16/2013
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