| NPI | 1528672961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILLIE JOHANNA ACOSTA RIVERA Behavior Analyst 407-952-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |