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Organization
PROGRESSIVE PEDIATRIC THERAPY SERVICES OF JACKSONVILLE
Active
Organization
PROGRESSIVE PEDIATRIC THERAPY SERVICES OF JACKSONVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY QUIN PREJEAN MA, CCC-SLP (CLINIC DIRECTOR)
(850) 325-6301
Entity
Organization
Contact information
Practice address
12350 SHORE ACRES DR, JACKSONVILLE, FL 32225-5670
(850) 325-6301
(850) 325-6302
Mailing address
1725 HERMITAGE BLVD, TALLAHASSEE, FL 32308-7709
(850) 325-6301
(850) 352-6302
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/09/2021
Last updated
06/09/2021
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