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Organization

BLUE SPRIGS PEDIACTRICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARKALISE MITCHELL (SENIOR CREDENTIALING SPECIALIST)
(281) 826-3382
Entity
Organization

Contact information

Practice address
1750 COMMERCE CENTER BLVD, FAIRBORN, OH 45324-6333
(937) 878-8444
Mailing address
1750 COMMERCE CENTER BLVD, FAIRBORN, OH 45324-6333
(937) 878-8444

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
05/13/2026
Last updated
05/13/2026
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