Individual
KRISTY CLEVELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 LAKE HOLLINGSWORTH DR, LAKELAND, FL 33803-2364
(863) 665-7300
Mailing address
527 EMERALD COVE LOOP, LAKELAND, FL 33813-2753
(863) 212-6936
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831560762
—
FL
Enumeration date
12/23/2019
Last updated
05/02/2022
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