| NPI | 1417603564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAYLA RENEE ELLIS Owner 813-514-5341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2022-02-28 |
| Last Update Date | 2022-02-28 |