Individual
ELLEN KINCAID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
1443 S CENTRAL AVE, FLAGLER BEACH, FL 32136-3761
(386) 503-3439
Mailing address
1443 S CENTRAL AVE, FLAGLER BEACH FL, FL 32136
(386) 503-3439
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
0-02-0592
FL
Other
Enumeration date
03/02/2016
Last updated
03/02/2016
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