| Keystone Behavioral Pediatrics, Llc | |
|
172 Canal Blvd Ponte Vedra Beach FL 32082-3606 | |
| (904) 373-0748 | |
| (904) 671-7377 |
| Full Name | Keystone Behavioral Pediatrics, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 172 Canal Blvd, Ponte Vedra Beach, Florida |
| Authorized Official Name and Position | Katherine Falwell (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9043730748 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keystone Behavioral Pediatrics, Llc 172 Canal Blvd Ponte Vedra Beach FL 32082-3606 Ph: (904) 373-0748 | Keystone Behavioral Pediatrics, Llc 172 Canal Blvd Ponte Vedra Beach FL 32082-3606 Ph: (904) 373-0748 |
| NPI Number | 1831365154 |
|---|---|
| Provider Enumeration Date | 05/06/2008 |
| Last Update Date | 05/12/2020 |
| Certification Date | 05/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831365154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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