Healthcare Provider Details

I. General information

NPI: 1427495761
Provider Name (Legal Business Name): BTEC BEHAVIORAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2013
Last Update Date: 05/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 W GARDEN ST
PENSACOLA FL
32502-4509
US

IV. Provider business mailing address

1508 W GARDEN ST
PENSACOLA FL
32502-4509
US

V. Phone/Fax

Practice location:
  • Phone: 850-483-1508
  • Fax: 251-986-3124
Mailing address:
  • Phone: 850-483-1508
  • Fax: 251-986-3124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: LAURI M TURNER
Title or Position: CLINICAL DIRECTOR
Credential: MA, BCBA
Phone: 850-483-1508