Provider Demographics
NPI:1972734432
Name:STEELE, JESSICA MARIE (RBT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:STEELE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MRS
Other - First Name:JESSICA
Other - Middle Name:MARIE
Other - Last Name:STEELE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RBT
Mailing Address - Street 1:220 WHITE OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32409-2370
Mailing Address - Country:US
Mailing Address - Phone:850-527-0460
Mailing Address - Fax:
Practice Address - Street 1:510 W 10TH ST
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-2329
Practice Address - Country:US
Practice Address - Phone:850-815-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA54572225700000X
FLRBT-23-298729106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC101SOtherBLUE CROSS BLUE SHEILD