| Inner Dynamics, Llc | |
|
50 Leanni Way Suite B-3 Palm Coast FL 32137-4751 | |
| (386) 313-6166 | |
| (386) 313-6166 |
| Full Name | Inner Dynamics, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 50 Leanni Way, Palm Coast, Florida |
| Authorized Official Name and Position | John Laforte (MGRM) |
| Authorized Official Contact | 3863136166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Dynamics, Llc 1 Rybark Pl Palm Coast FL 32164-6440 Ph: (386) 313-6166 | Inner Dynamics, Llc 50 Leanni Way Suite B-3 Palm Coast FL 32137-4751 Ph: (386) 313-6166 |
| NPI Number | 1639450034 |
|---|---|
| Provider Enumeration Date | 08/30/2011 |
| Last Update Date | 08/30/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639450034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW9614 (Florida) | Primary |
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