| B L C | |
|
7940 Front Beach Rd # 2148 Panama City Beach FL 32407-4817 | |
| (850) 427-3079 | |
| Not Available |
| Full Name | B L C |
|---|---|
| Speciality | Behavior Analyst |
| Location | 7940 Front Beach Rd # 2148, Panama City Beach, Florida |
| Authorized Official Name and Position | Deaundra Jackson (MEMBER) |
| Authorized Official Contact | 8502724940 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| B L C Po Box 5812 Marianna FL 32447-5812 Ph: () - | B L C 7940 Front Beach Rd # 2148 Panama City Beach FL 32407-4817 Ph: (850) 427-3079 |
| NPI Number | 1457946238 |
|---|---|
| Provider Enumeration Date | 03/04/2021 |
| Last Update Date | 09/19/2023 |
| Certification Date | 09/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457946238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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