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Organization
BAYSIDE NEUROTHERAPY, LLC
Active
Organization
BAYSIDE NEUROTHERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CYNTHIA LEIGH WILSON LP (LICENSED CLINICAL PSYCHOLOGIST)
(850) 541-8520
Entity
Organization
Contact information
Practice address
1022 W 23RD ST STE 530, PANAMA CITY, FL 32405-3688
(850) 541-8520
(850) 541-9928
Mailing address
1022 W 23RD ST STE 530, PANAMA CITY, FL 32405-3688
(850) 541-8520
(850) 541-9928
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/08/2018
Last updated
10/08/2018
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