Individual
LYLE J SANDQUIST
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD LMFT
Contact information
Practice address
215 MOUNTAIN DRIVE, STE 106, DESTIN, FL 32541-2346
(850) 837-9100
(850) 837-7300
Mailing address
215 MOUNTAIN DRIVE, STE 106, DESTIN, FL 32541-2346
(850) 837-9100
(850) 837-7300
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT1053
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z1714
BCBS
FL
Enumeration date
11/29/2005
Last updated
07/08/2007
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