| NPI | 1255162947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANA MARIE JANUARY Owner 321-754-0686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2024-08-13 |
| Last Update Date | 2024-08-13 |