Individual
KIMBERLY BOGGS-MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
545 E 7TH AVE APT 102, TALLAHASSEE, FL 32303-5649
(850) 274-7777
Mailing address
545 E 7TH AVE APT 102, TALLAHASSEE, FL 32303-5649
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/28/2017
Last updated
09/25/2017
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