| NPI | 1518112416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA J AUGUST Managing Member 904-374-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics |
| 235Z00000X Speech-Language Pathologist, | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2013-07-08 |