| Gulf Coast Autism Clinic, Llc | |
|
2404 Ruth Hentz Ave Bldg B Panama City FL 32405-2258 | |
| (850) 628-7572 | |
| Not Available |
| Full Name | Gulf Coast Autism Clinic, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2404 Ruth Hentz Ave Bldg B, Panama City, Florida |
| Authorized Official Name and Position | Kuryn Patterson (CEO) |
| Authorized Official Contact | 8506287572 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulf Coast Autism Clinic, Llc 2404 Ruth Hentz Ave Bldg B Panama City FL 32405-2258 Ph: (850) 628-7572 | Gulf Coast Autism Clinic, Llc 2404 Ruth Hentz Ave Bldg B Panama City FL 32405-2258 Ph: (850) 628-7572 |
| NPI Number | 1013517143 |
|---|---|
| Provider Enumeration Date | 10/28/2020 |
| Last Update Date | 10/28/2020 |
| Certification Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013517143 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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