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General NPI Number Information
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NPI Number | 1184024341
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Entity Type | Organization
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Legal Business Name | DAMON LABARBERA, PHD
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Dates
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Enumeration Date | 08/25/2014
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Last Update Date | 08/25/2014
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Provider Practice Location Address
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Address Line | 439 GRACE AVE
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City | PANAMA CITY
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State | FL
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Zip | 32401-2721
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Country | US
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Telephone | 850-763-2984
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Fax | 904-214-0022
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Provider Business Mailing Address
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Address Line | 439 GRACE AVE
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City | PANAMA CITY
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State | FL
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Zip | 32401-2721
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Country | US
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Telephone | 850-763-2984
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Fax | 904-214-0022
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAMON LABARBERA
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Credential |
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Telephone | 850-763-2984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY0004085
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License Number State | FL
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