Individual
AMANDA LAYNE COCKRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4750 COLLEGIATE DR, PANAMA CITY, FL 32405-1000
(850) 770-2241
Mailing address
4750 COLLEGIATE DR, PANAMA CITY, FL 32405-1000
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12043824
FL
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/27/2018
Last updated
12/22/2020
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