Growing Well Fbs | |
20114 East Pennsylvania Avenue Dunnellon FL 34432 | |
(352) 465-2444 | |
(352) 465-7854 |
Full Name | Growing Well Fbs |
---|---|
Speciality | Psychologist - School |
Location | 20114 East Pennsylvania Avenue, Dunnellon, Florida |
Authorized Official Name and Position | Mary Ann Ellis (SCHOOL PSYCHOLOGIST) |
Authorized Official Contact | 3524652444 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Growing Well Fbs 20114 E Pennsylvania Ave Dunnellon FL 34432-6033 Ph: (352) 465-2444 | Growing Well Fbs 20114 East Pennsylvania Avenue Dunnellon FL 34432 Ph: (352) 465-2444 |
NPI Number | 1639229362 |
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Provider Enumeration Date | 01/12/2007 |
Last Update Date | 03/11/2020 |
Certification Date | 03/11/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639229362 | NPI | - | NPPES |
691219296 | Other | FL | STATE OF FL AGENCY FOR PE |
691219298 | Other | FL | STATE OF FL AGENCY FOR PE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TS0200X | Psychologist - School | SS830 (Florida) | Primary |
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