Individual
KAWANZA SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OWNER, REGISTEINTERN
Contact information
Practice address
6866 PINE FOREST RD STE A, PENSACOLA, FL 32526-6903
(850) 972-9897
(850) 972-9898
Mailing address
6888 PINE FOREST ROAD, SUITE A, PENSACOLA, FL 32526-2673
(850) 972-9897
(850) 972-9898
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
15681
FL
101Y00000X
Counselor
1830
FL
101YM0800X
Mental Health Counselor
1830
FL
101YP2500X
Professional Counselor
1830
FL
103K00000X
Behavior Analyst
1830
FL
251C00000X
Developmentally Disabled Services Day Training Agency
1830
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
$$$$$$$$$
—
FL
05
—
1841785482
—
FL
05
—
1881189421
—
FL
Enumeration date
06/26/2018
Last updated
04/05/2022
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