Organization
PENSACOLA PSYCHOLOGICAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN GROOM PHD (OWNER)
(850) 433-1656
Entity
Organization
Contact information
Practice address
3 W GARDEN ST, STE 370, PENSACOLA, FL 32502-5641
(850) 433-1656
(850) 433-1996
Mailing address
229 S BAYLEN ST, STE 2, PENSACOLA, FL 32502-5852
(850) 433-1656
(850) 433-1996
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
12/14/2006
Last updated
10/22/2007
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