Organization
COASTAL THERAPY ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHRYN MAE LAND PMHNP-BC (PARTNER)
(850) 209-5935
Entity
Organization
Contact information
Practice address
3050 W HIGHWAY 98 UNIT B7, PORT ST JOE, FL 32456-4718
(850) 209-5935
Mailing address
3050 W HIGHWAY 98 UNIT B7, PORT ST JOE, FL 32456-4718
(850) 209-5935
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2801262
FL
Other
Enumeration date
06/05/2018
Last updated
03/03/2021
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