| NPI | 1134724263 |
|---|---|
| Former Legal Business Name | D. MACK CONSULTING LLC |
| Entity Type | Organization |
| Authorized Contact | DARRIEN DENARD MACK Registered Behavior Technician 850-774-5832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2020-12-04 |