| Bct | |
|
201 6th Ave Indialantic FL 32903-3303 | |
| (321) 544-4351 | |
| (321) 775-3484 |
| Full Name | Bct |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 201 6th Ave, Indialantic, Florida |
| Authorized Official Name and Position | Susan Marie Jennings (PRESIDENT) |
| Authorized Official Contact | 3215444351 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bct 201 6th Ave Indialantic FL 32903-3303 Ph: (321) 544-4351 | Bct 201 6th Ave Indialantic FL 32903-3303 Ph: (321) 544-4351 |
| NPI Number | 1962886044 |
|---|---|
| Provider Enumeration Date | 07/17/2015 |
| Last Update Date | 07/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962886044 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH7350 (Florida) | Primary |
| 103K00000X | Behavior Analyst | 1-00-0132 (Florida) | Secondary |
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