Provider Demographics
NPI:1427764422
Name:THERAPEUTIC TOUCH
Entity type:Organization
Organization Name:THERAPEUTIC TOUCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTIONETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-694-7555
Mailing Address - Street 1:PO BOX 841
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:FL
Mailing Address - Zip Code:32343-0841
Mailing Address - Country:US
Mailing Address - Phone:850-694-7555
Mailing Address - Fax:
Practice Address - Street 1:350 N CHARLES WILLIS DR
Practice Address - Street 2:
Practice Address - City:MIDWAY
Practice Address - State:FL
Practice Address - Zip Code:32343-4293
Practice Address - Country:US
Practice Address - Phone:850-694-7555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty