| NPI | 1861104135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARREECHA NEWBY Owner 904-855-6408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2022-12-19 |