Organization
EMERALD COAST AUTISM CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACI BERRYMAN BCBA (EXECUTIVE DIRECTOR)
(850) 279-3000
Entity
Organization
Contact information
Practice address
200 PARTIN DR N, NICEVILLE, FL 32578-1244
(850) 279-3000
Mailing address
200 PARTIN DR N, NICEVILLE, FL 32578-1244
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA11523
FL
Other
Enumeration date
04/16/2012
Last updated
04/16/2012
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