Organization
BEACON PEDIATRIC BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADRIENNE LEIGH DESANTIS KING PHD, BCBA-D, NCSP (MANAGING MEMBER/OWNER/PSYCHOLOGIST)
(904) 419-7792
Entity
Organization
Contact information
Practice address
6816 SOUTHPOINT PKWY STE 202, JACKSONVILLE, FL 32216-1701
(904) 419-7792
(904) 900-7732
Mailing address
6816 SOUTHPOINT PKWY STE 202, JACKSONVILLE, FL 32216-1701
(904) 419-7792
(904) 900-7732
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
07/16/2012
Last updated
06/16/2018
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