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WILLIAM COREY FORREST RBT
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1487115028
Individual Registrant: WILLIAM COREY FORREST RBT
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
1306 CONNECTICUT AVE LYNN HAVEN, FL 32444-2030 US
Tel: 850-628-9341 Fax: --
Tel: 850-628-9341 Fax: --
Contact information for business:
1306 CONNECTICUT AVE LYNN HAVEN, FL 32444-2030 US
Tel: 850-628-9341 Fax: --
Tel: 850-628-9341 Fax: --
Registration Information:
NPI: 1487115028
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 020523400 | FL | 05 |
