| NPI | 1114654431 |
|---|---|
| Doing Business As | BLUE TIDE THERAPY |
| Entity Type | Organization |
| Authorized Contact | GARRETT OUTLAND Owner/Speech Language Pathologist 850-964-6162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 225700000X Massage Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2025-01-13 |