Organization
ALYSIA GILLIAM CONSULTING
Active
Other names
Pediatric Behavioral Services, LLC, PBS
Organization subpart
No
Provider details
NPI number
Authorized official
ALYSIA GILLIAM (BOARD CERTIFIED BEHAVIOR ANALYST)
(904) 329-0028
Entity
Organization
Contact information
Practice address
1335 KINGSLEY AVE # 2472, ORANGE PARK, FL 32073-4507
(904) 329-0028
(866) 818-7176
Mailing address
1335 KINGSLEY AVE # 2472, ORANGE PARK, FL 32073-4507
(904) 329-0028
(866) 818-7176
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019773100
—
FL
Enumeration date
03/03/2010
Last updated
02/28/2019
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