| NPI | 1912459629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY QUIN PREJEAN Clinic Director 850-325-6301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2020-12-18 |