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Organization
PICKY EATERS ONLINE INC
Active
Organization
PICKY EATERS ONLINE INC
Active
Other names
Picky Eaters Online INC
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY KOMISARUK M.ED, CCC-SLP (PRESIDENT)
(321) 388-2924
Entity
Organization
Contact information
Practice address
5030 HARTWELL CT, SAINT CLOUD, FL 34771-7936
(321) 388-2924
Mailing address
5030 HARTWELL CT, SAINT CLOUD, FL 34771-7936
(321) 388-2924
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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