| NPI | 1730612185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LABRINA A JACKSON Owner 407-719-3024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA13099) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| 101YM0800X Counselor, Mental Health | |
| 225100000X Physical Therapist | |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2018-03-07 |