Provider Demographics
NPI:1457490229
Name:LABARBERA, DAMON G (PHD)
Entity type:Individual
Prefix:DR
First Name:DAMON
Middle Name:G
Last Name:LABARBERA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 JENKS AVE
Mailing Address - Street 2:SUITE #4
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401
Mailing Address - Country:US
Mailing Address - Phone:850-763-2984
Mailing Address - Fax:904-214-0022
Practice Address - Street 1:803 JENKS AVE
Practice Address - Street 2:SUITE #4
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401
Practice Address - Country:US
Practice Address - Phone:850-763-2984
Practice Address - Fax:904-214-0022
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4085103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
73473OtherBCBS
105096OtherVALUE OPTIONS
105096OtherVALUE OPTIONS