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Organization

PANHANDLE THERAPY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HEATHER MONTFORD KING LCSW (DIRECTOR)
(850) 447-4546
Entity
Organization

Contact information

Practice address
20311 CENTRAL AVE W, BLOUNTSTOWN, FL 32424-1947
(850) 674-8888
(850) 237-1223
Mailing address
20311 CENTRAL AVE W, BLOUNTSTOWN, FL 32424-1947
(850) 674-8888
(850) 237-1223

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
252Y00000X
Early Intervention Provider Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
01/24/2020
Last updated
07/11/2024
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