Organization
BLUEWATER BEHAVIORAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE VELASQUEZ (COOWNER, BUSINESS MANAGER)
(850) 842-9750
Entity
Organization
Contact information
Practice address
4451 PARKWOOD SQ, NICEVILLE, FL 32578-9707
(850) 842-9750
Mailing address
4451 PARKWOOD SQ, NICEVILLE, FL 32578-9707
(850) 842-9750
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-16721
CO
Other
Enumeration date
11/14/2016
Last updated
11/02/2017
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