| Doctor Name: | MR. JOEL GLENN PRATHER |
| NPI Number: | 1063633444 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D, LMHC |
| License Number: | MH9104 |
| Business Practice Address: | 12133 Panama City Beach Pkwy Panama City Beach, FL - 324072609 |
| Business Phone Number: | 8502499636 |
| Business Fax Number: | 8502499635 |
| Mailing Address: | 12133 Panama City Beach Pkwy, PANAMA CITY BEACH |
| State: | FL |
| Postal Code: | 324072609 |
| Phone Number: | 8502499636 |
| Fax Number: | 8502499635 |
| NPI Enumeration Date: | 05/01/2007 |
| NPI Last Update Date: | 04/05/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH9104 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |