Individual
CARSON PENNYPACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
(352) 374-5600
(352) 244-2741
Mailing address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
(352) 374-5600
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
SW17353
FL
Other
Enumeration date
07/14/2015
Last updated
07/10/2020
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