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Organization
RISING PALMS BEHAVIORAL PEDIATRICS
Active
Organization
RISING PALMS BEHAVIORAL PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ASHLEY VICKERY KISER MA, BCBA (CHIEF EXECUTIVE OFFICER)
(256) 504-8841
Entity
Organization
Contact information
Practice address
12077 DIAMOND SPRINGS DR, JACKSONVILLE, FL 32246-0597
(256) 504-8841
Mailing address
12077 DIAMOND SPRINGS DR, JACKSONVILLE, FL 32246-0597
(256) 504-8841
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-10529
FL
Other
Enumeration date
09/22/2017
Last updated
07/21/2022
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