Organization
SUNRISE MENTAL HEALTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA JOHNSON (OFFICE MANAGER)
(850) 244-9333
Entity
Organization
Contact information
Practice address
250 BROOKS STREET, SUITE C, FORT WALTON BEACH, FL 32548
(850) 244-9333
(850) 244-9338
Mailing address
250 BROOKS STREET, SUITE C, FORT WALTON BEACH, FL 32548
(850) 244-9333
(850) 244-9338
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
ME62603
FL
Other
Enumeration date
11/05/2007
Last updated
11/14/2007
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