Organization
GULF COAST NEUROPSYCHOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN KELLY O'NEAL PSY.D. (OWNER)
(941) 993-3074
Entity
Organization
Contact information
Practice address
2650 BAHIA VISTA ST, SUITE 201, SARASOTA, FL 34239-2635
(941) 993-3074
Mailing address
2650 BAHIA VISTA ST, SUITE 201, SARASOTA, FL 34239-2635
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
05/30/2013
Last updated
05/30/2013
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