| Holladay Child Development Services,llc | |
|
5302 S Florida Ave Suite 202 Lakeland FL 33813-4922 | |
| (863) 937-8067 | |
| (863) 607-6207 |
| Full Name | Holladay Child Development Services,llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 5302 S Florida Ave, Lakeland, Florida |
| Authorized Official Name and Position | Joanna Marie Sitta (OWNER) |
| Authorized Official Contact | 8639378067 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Holladay Child Development Services,llc 5302 S Florida Ave Suite 202 Lakeland FL 33813-4922 Ph: (863) 937-8067 | Holladay Child Development Services,llc 5302 S Florida Ave Suite 202 Lakeland FL 33813-4922 Ph: (863) 937-8067 |
| NPI Number | 1295067593 |
|---|---|
| Provider Enumeration Date | 02/11/2010 |
| Last Update Date | 10/11/2024 |
| Certification Date | 10/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295067593 | NPI | - | NPPES |
| 01443200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-04-1686 (Florida) | Primary |
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