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Organization
NEURODIVERSE ABILITY SERVICES LLC
Active
Organization
NEURODIVERSE ABILITY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAULA LYNETTE MILLER PH.D (PRESIDENT/CEO)
(386) 965-5197
Entity
Organization
Contact information
Practice address
608 SW MARVIN BURNETT RD, LAKE CITY, FL 32025-4918
(386) 965-5197
Mailing address
664 SW MAULDIN AVE, LAKE CITY, FL 32024-4791
(386) 965-5197
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
—
—
103TS0200X
School Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
11/02/2020
Last updated
04/05/2021
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