Individual
AUSTIN KELL DANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
240 N FREDERICK AVE, DAYTONA BEACH, FL 32114-3400
(386) 675-0205
Mailing address
240 N FREDERICK AVE, DAYTONA BEACH, FL 32114-3400
(386) 675-0205
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20555
FL
Other
Enumeration date
06/25/2024
Last updated
06/25/2024
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