| Rising Palms Behavioral Pediatrics | |
|
12077 Diamond Springs Dr Jacksonville FL 32246-0597 | |
| (256) 504-8841 | |
| Not Available |
| Full Name | Rising Palms Behavioral Pediatrics |
|---|---|
| Speciality | Behavior Analyst |
| Location | 12077 Diamond Springs Dr, Jacksonville, Florida |
| Authorized Official Name and Position | Ashley Vickery Kiser (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2565048841 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rising Palms Behavioral Pediatrics 12077 Diamond Springs Dr Jacksonville FL 32246-0597 Ph: (256) 504-8841 | Rising Palms Behavioral Pediatrics 12077 Diamond Springs Dr Jacksonville FL 32246-0597 Ph: (256) 504-8841 |
| NPI Number | 1275042269 |
|---|---|
| Provider Enumeration Date | 09/22/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275042269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-12-10529 (Florida) | Primary |
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