| Growing Well Family Behavioral Services | |
|
20114 East Pennsylvania Avenue Dunnellon FL 34432 | |
| (352) 465-2444 | |
| (352) 465-7854 |
| Full Name | Growing Well Family Behavioral Services |
|---|---|
| Speciality | Psychologist - School |
| Location | 20114 East Pennsylvania Avenue, Dunnellon, Florida |
| Authorized Official Name and Position | Mary Ann Ellis (SCHOOL PSYCHOLOGIST) |
| Authorized Official Contact | 3524652444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Growing Well Family Behavioral Services 20114 E Pennsylvania Ave Dunnellon FL 34432-6033 Ph: (352) 465-2444 | Growing Well Family Behavioral Services 20114 East Pennsylvania Avenue Dunnellon FL 34432 Ph: (352) 465-2444 |
| NPI Number | 1639229362 |
|---|---|
| Provider Enumeration Date | 01/12/2007 |
| Last Update Date | 03/11/2020 |
| Certification Date | 03/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639229362 | NPI | - | NPPES |
| 691219296 | Other | FL | STATE OF FL AGENCY FOR PE |
| 691219298 | Other | FL | STATE OF FL AGENCY FOR PE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TS0200X | Psychologist - School | SS830 (Florida) | Primary |
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