Individual
BRENT DECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
11 W 23RD ST BLDG D1, PANAMA CITY, FL 32405-4553
(850) 522-9456
(850) 522-9094
Mailing address
11 W 23RD ST BLDG D1, PANAMA CITY, FL 32405-4553
(850) 522-9456
(850) 522-9094
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY5989
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54477
BC/BS OF FLORIDA
FL
Enumeration date
08/10/2006
Last updated
04/02/2019
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