| Shoreline Center For Exceptional Students, Llc | |
|
528 Cecil G Costin Sr Blvd Ste A Port St Joe FL 32456-1754 | |
| (850) 227-1163 | |
| Not Available |
| Full Name | Shoreline Center For Exceptional Students, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 528 Cecil G Costin Sr Blvd Ste A, Port St Joe, Florida |
| Authorized Official Name and Position | Tracie Ann Cumbie (BEHAVIOR ANALYST) |
| Authorized Official Contact | 8502275759 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoreline Center For Exceptional Students, Llc 528 Cecil G Costin Sr Blvd Ste A Port St Joe FL 32456-1754 Ph: (850) 227-5759 | Shoreline Center For Exceptional Students, Llc 528 Cecil G Costin Sr Blvd Ste A Port St Joe FL 32456-1754 Ph: (850) 227-1163 |
| NPI Number | 1891303244 |
|---|---|
| Provider Enumeration Date | 07/21/2020 |
| Last Update Date | 07/21/2020 |
| Certification Date | 07/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891303244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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