Organization
KEYSTONE BEHAVIORAL PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW DELANEY BCBA (CHIEF CLINICAL OFFICER)
(904) 373-0082
Entity
Organization
Contact information
Practice address
171 CANAL BLVD STE 2, PONTE VEDRA BEACH, FL 32082-3607
(904) 373-0082
(904) 671-7377
Mailing address
172 CANAL BLVD, PONTE VEDRA BEACH, FL 32082-3606
(904) 373-0082
(904) 671-7377
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
02/24/2022
Last updated
02/24/2022
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