Individual
MRS. PENNY L. RALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
704 N COTTON ST, BONIFAY, FL 32425-1510
(850) 547-9106
Mailing address
704 N COTTON ST, BONIFAY, FL 32425-1510
(850) 547-9106
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
675991296
—
FL
Enumeration date
10/12/2006
Last updated
07/09/2007
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