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Organization
PONTE VEDRA BEHAVIORAL HEALTH LLC
Active
Organization
PONTE VEDRA BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BUSAYO MARY ENIKANOSELU STELBEN BCBA (MANAGING MEMBER/CLINICAL DIRECTOR)
(571) 398-1908
Entity
Organization
Contact information
Practice address
90 FORT WADE RD STE 100, PONTE VEDRA, FL 32081-5114
(571) 398-1908
(386) 800-3358
Mailing address
252 CAIDEN DR, PONTE VEDRA, FL 32081-1101
(571) 398-1908
(386) 800-3358
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/16/2026
Last updated
02/16/2026
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