Organization
BRILLIANT MINDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS GINA M BALLONE (CLINCAL DIRECTOR)
(850) 837-1200
Entity
Organization
Contact information
Practice address
36468 EMERALD COAST PKWY, SUITE 2101, DESTIN, FL 32541-4799
(850) 837-1200
(850) 269-2341
Mailing address
36468 EMERALD COAST PKWY, SUITE 2101, DESTIN, FL 32541
(850) 837-1200
(850) 269-2341
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
90051001284
FL
Other
Enumeration date
04/06/2007
Last updated
08/22/2020
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