| 505 Family Therapy | |
|
1758 Sioux Trl Gulf Breeze FL 32563-9257 | |
| (505) 234-6262 | |
| Not Available |
| Full Name | 505 Family Therapy |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1758 Sioux Trl, Gulf Breeze, Florida |
| Authorized Official Name and Position | Annalyse Lucero (OWNER) |
| Authorized Official Contact | 5052610923 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 505 Family Therapy 1758 Sioux Trl Gulf Breeze FL 32563-9257 Ph: (505) 234-6262 | 505 Family Therapy 1758 Sioux Trl Gulf Breeze FL 32563-9257 Ph: (505) 234-6262 |
| NPI Number | 1689455149 |
|---|---|
| Provider Enumeration Date | 10/11/2023 |
| Last Update Date | 10/11/2023 |
| Certification Date | 10/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689455149 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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