Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 9214 | FL |
Y | 103TC0700X | Clinical Psychologist | 9214 | FL |
N | 103TR0400X | Rehabilitation Psychologist | PSY003849 | GA |
NPI | 1619296555 |
---|---|
Provider Name | Dr. Zachary Clark Bayer |
First Address | Fort Walton Beach, FL 32548-5069 |
Second Address | Fort Walton Beach, FL 32548-5069 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2010 |
Last Update Date | 19/08/2016 |