Organization
DIVINE DELIVERANCE THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LABRINA A JACKSON CCC/SLP (OWNER)
(407) 719-3024
Entity
Organization
Contact information
Practice address
5401 S KIRKMAN RD STE 310, ORLANDO, FL 32819-7937
(407) 719-3024
Mailing address
5401 S KIRKMAN RD STE 310, ORLANDO, FL 32819-7937
(866) 330-6427
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
SA13099
FL
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
04/04/2017
Last updated
03/07/2018
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