Individual
SILVER ISOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2105 PARK AVE STE 5, ORANGE PARK, FL 32073-5557
(904) 778-5223
Mailing address
PO BOX 65271, ORANGE PARK, FL 32065-0005
(904) 778-5223
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
10/02/2018
Last updated
02/24/2023
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