| Bayside Psychology Services, Llc | |
|
4400 E Highway 20 Ste 305 Niceville FL 32578-8779 | |
| (850) 279-6750 | |
| (850) 279-6752 |
| Full Name | Bayside Psychology Services, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 4400 E Highway 20, Niceville, Florida |
| Authorized Official Name and Position | Gretchen Chapman Tyler (LICENSED PSYCHOLOGIST / PRESIDENT) |
| Authorized Official Contact | 8502796750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bayside Psychology Services, Llc 4400 E Highway 20 Ste 305 Niceville FL 32578-8779 Ph: (850) 279-6750 | Bayside Psychology Services, Llc 4400 E Highway 20 Ste 305 Niceville FL 32578-8779 Ph: (850) 279-6750 |
| NPI Number | 1922388909 |
|---|---|
| Provider Enumeration Date | 08/23/2011 |
| Last Update Date | 08/23/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922388909 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 5264 (Florida) | Primary |
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