Individual
RACQUEL MCZEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3625 NANTUCKET ISLAND DR APT 104, PORT ORANGE, FL 32129-5345
(386) 341-0118
Mailing address
3625 NANTUCKET ISLAND DR APT 104, PORT ORANGE, FL 32129-5345
(386) 341-0118
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/25/2019
Last updated
08/25/2019
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