Organization
CATHY SUPON CONNOR LLC
Active
Organization
CATHY SUPON CONNOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHY SUPON CONNOR LCSW (LCSW/OWNER)
(850) 381-1520
Entity
Organization
Contact information
Practice address
429 S TYNDALL PKWY STE G, PANAMA CITY, FL 32404-6746
(850) 381-3701
Mailing address
429 S TYNDALL PKWY STE G, PANAMA CITY, FL 32404-6746
(850) 381-3701
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW8892
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
769063100
—
FL
Enumeration date
03/03/2014
Last updated
05/23/2014
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