| Antidote Wellness Llc | |
|
5435 Japonica Ave Pensacola FL 32507-8848 | |
| (850) 332-3087 | |
| Not Available |
| Full Name | Antidote Wellness Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5435 Japonica Ave, Pensacola, Florida |
| Authorized Official Name and Position | Amanda L Haggard (SOLE OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 8503323087 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Antidote Wellness Llc 5435 Japonica Ave Pensacola FL 32507-8848 Ph: (850) 332-3087 | Antidote Wellness Llc 5435 Japonica Ave Pensacola FL 32507-8848 Ph: (850) 332-3087 |
| NPI Number | 1043817786 |
|---|---|
| Provider Enumeration Date | 10/06/2020 |
| Last Update Date | 10/06/2020 |
| Certification Date | 10/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043817786 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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