| |
4400 Bayou Blvd Building #51 Pensacola FL 32503-2673 | |
(850) 484-8344 | |
(850) 484-2875 |
Full Name | |
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Speciality | Psychologist |
Location | 4400 Bayou Blvd, Pensacola, Florida |
Authorized Official Name and Position | Linda D. Huggins (OFFICE MANAGER) |
Authorized Official Contact | 8504848344 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4400 Bayou Blvd Building #51 Pensacola FL 32503-2673 Ph: (850) 484-8344 | 4400 Bayou Blvd Building #51 Pensacola FL 32503-2673 Ph: (850) 484-8344 |
NPI Number | 1659775823 |
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Provider Enumeration Date | 10/17/2014 |
Last Update Date | 06/20/2018 |
Identifier | Type | State | Issuer |
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1659775823 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | PY2286 (Florida) | Primary |
106H00000X | Marriage & Family Therapist | MT900 (Florida) | Secondary |
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