Organization
GROWING WELL FAMILY BEHAVIORAL SERVICES
Active
Other names
Growing Well Family Behavioral Services, Growing Well FBS
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN ELLIS EDS (SCHOOL PSYCHOLOGIST)
(352) 465-2444
Entity
Organization
Contact information
Practice address
20114 EAST PENNSYLVANIA AVENUE, DUNNELLON, FL 34432
(352) 465-2444
(352) 465-7854
Mailing address
20114 E PENNSYLVANIA AVE, DUNNELLON, FL 34432-6033
(352) 465-2444
(352) 465-7854
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
SS830
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
691219296
STATE OF FL AGENCY FOR PE
FL
01
—
691219298
STATE OF FL AGENCY FOR PE
FL
Enumeration date
01/12/2007
Last updated
03/11/2020
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