| Santa Rosa County School Board | |
|
6751 Berryhill St Milton FL 32570-4790 | |
| (850) 983-5151 | |
| (850) 983-5577 |
| Full Name | Santa Rosa County School Board |
|---|---|
| Speciality | Psychologist - School |
| Location | 6751 Berryhill St, Milton, Florida |
| Authorized Official Name and Position | Roderick C. Gracey (DIRECTOR STUDENT SERVICES) |
| Authorized Official Contact | 8509835587 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Santa Rosa County School Board 6751 Berryhill St Milton FL 32570-4790 Ph: (850) 983-5151 | Santa Rosa County School Board 6751 Berryhill St Milton FL 32570-4790 Ph: (850) 983-5151 |
| NPI Number | 1013078104 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 01/29/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013078104 | NPI | - | NPPES |
| 081005317 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TS0200X | Psychologist - School | (* (Not Available)) | Primary |
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