Healthcare Provider Details

I. General information

NPI: 1215630694
Provider Name (Legal Business Name): THERAPY JUNCTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2023
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2924 KINGS RD
PANAMA CITY FL
32405-2016
US

IV. Provider business mailing address

2924 KINGS RD
PANAMA CITY FL
32405-2016
US

V. Phone/Fax

Practice location:
  • Phone: 850-258-2638
  • Fax:
Mailing address:
  • Phone: 850-258-2638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. SANITA TANETTE OWENS
Title or Position: PRESIDENT
Credential: BCBA
Phone: 850-258-2638