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Organization
SOURCE ROUTE PRODUCTS, LLC
Active
Organization
SOURCE ROUTE PRODUCTS, LLC
Active
Other names
SRP, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY MILLS PH.D, BCBA (MEMBER)
(202) 480-9234
Entity
Organization
Contact information
Practice address
3795 E PARSONS POINT RD, BOX 1047, HERNANDO, FL 34442-7701
(202) 480-9234
Mailing address
3795 E PARSONS POINT RD, BOX 1047, HERNANDO, FL 34442-7701
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-12087
FL
Other
Enumeration date
11/05/2012
Last updated
11/05/2012
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