Provider Demographics
NPI:1205471422
Name:MURPHY, BIANCA S
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:S
Last Name:MURPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3219 THOMASVILLE RD APT 1C
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-7916
Mailing Address - Country:US
Mailing Address - Phone:850-210-3961
Mailing Address - Fax:
Practice Address - Street 1:3219 THOMASVILLE RD APT 1C
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-7916
Practice Address - Country:US
Practice Address - Phone:850-210-3961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker