| Bayside Neurotherapy, Llc | |
|
1022 W 23rd St Ste 530 Panama City FL 32405-3688 | |
| (850) 541-8520 | |
| (850) 541-9928 |
| Full Name | Bayside Neurotherapy, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1022 W 23rd St Ste 530, Panama City, Florida |
| Authorized Official Name and Position | Cynthia Leigh Wilson (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8505418520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bayside Neurotherapy, Llc 1022 W 23rd St Ste 530 Panama City FL 32405-3688 Ph: (850) 541-8520 | Bayside Neurotherapy, Llc 1022 W 23rd St Ste 530 Panama City FL 32405-3688 Ph: (850) 541-8520 |
| NPI Number | 1043785926 |
|---|---|
| Provider Enumeration Date | 10/08/2018 |
| Last Update Date | 10/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043785926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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