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3831 W Vine St Ste 60 Kissimmee FL 34741-4650 | |
| (407) 559-4854 | |
| (407) 965-4480 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3831 W Vine St Ste 60, Kissimmee, Florida |
| Authorized Official Name and Position | Maegen Christine Pierce (FOUNDER CEO) |
| Authorized Official Contact | 4075744629 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2301 Maitland Center Pkwy Ste 240 Maitland FL 32751-7415 Ph: () - | 3831 W Vine St Ste 60 Kissimmee FL 34741-4650 Ph: (407) 559-4854 |
| NPI Number | 1033887609 |
|---|---|
| Provider Enumeration Date | 08/31/2021 |
| Last Update Date | 05/03/2022 |
| Certification Date | 05/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033887609 | NPI | - | NPPES |
| 107474802 | Medicaid | FL |
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