| Coastal Behavioral Services, Llc | |
|
10135 Montague St Tampa FL 33626-1857 | |
| (813) 401-2539 | |
| Not Available |
| Full Name | Coastal Behavioral Services, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 10135 Montague St, Tampa, Florida |
| Authorized Official Name and Position | Crystal Lagor (OWNER) |
| Authorized Official Contact | 8134012539 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Behavioral Services, Llc 10135 Montague St Tampa FL 33626-1857 Ph: (813) 401-2539 | Coastal Behavioral Services, Llc 10135 Montague St Tampa FL 33626-1857 Ph: (813) 401-2539 |
| NPI Number | 1598345514 |
|---|---|
| Provider Enumeration Date | 04/13/2021 |
| Last Update Date | 04/16/2021 |
| Certification Date | 04/16/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598345514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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