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General NPI Number Information
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NPI Number | 1376278606
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Entity Type | Organization
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Legal Business Name | GULF BREEZE THERAPY, LLC
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Dates
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Enumeration Date | 07/20/2022
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 1354 COUNTRY CLUB RD
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City | GULF BREEZE
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State | FL
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Zip | 32563-3471
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Country | US
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Telephone | 850-378-3517
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Fax | 855-682-6103
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Provider Business Mailing Address
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Address Line | 210 FIRETHORN RD
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City | GULF BREEZE
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State | FL
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Zip | 32561-4318
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Country | US
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Telephone | 850-737-6864
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | BECCA PIESKE
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Credential |
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Telephone | 850-716-2693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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