NPI | 1538676671 |
---|---|
Former Legal Business Name | SOUTHEASTERN PSYCHOLOGICAL SERVICES FOR CHILDREN & ADOLESCENTS, LLC |
Entity Type | Organization |
Authorized Contact | KATHERINE DICKINSON Owner 850-841-9836 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Enumeration Date | 2018-01-10 |
Last Update Date | 2022-12-15 |