Dynitia Brimm

Individual provider Active NPI Clinical Social Worker · Crawfordville, FL

NPI 1386771202 · NPPES record last updated Nov 1, 2014

Key facts

NPI
1386771202
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
SW4772 (FL)
Practice address
129 Revell Rd
Crawfordville, FL 32327-2417
Phone
(850) 926-2921
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
SW4772FLMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW4772 FL Yes

Addresses

Primary practice location

129 Revell Rd
Crawfordville, FL 32327-2417

Mailing address

129 Revell Rd
Crawfordville, FL 32327-2417
Phone (850) 926-2921

Other providers in Crawfordville, FL

All providers in Crawfordville, FL · Clinical Social Worker in Florida

Sources for this page

Verify at the official NPI Registry.