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Jessica Marie Bastian
Developmental Disabilities Clinic/Center in Leesburg, Florida
NPI 1518596030

Jessica Marie Bastian is a Developmental Disabilities Clinic/Center based in Tavares, FL and is specialized in Developmental Disabilities. Jessica Marie Bastian practices in Leesburg, FL. The NPI Number for Jessica Marie Bastian is 1518596030 and holds a License No. (Florida).

The current practice location address for Jessica Marie Bastian is 1704 W Main St, Leesburg, FL and can be reached out via phone at 352-702-1478.

Location: 1704 W Main St, Leesburg, FL, 32778-0043
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518596030
Provider Name
Jessica Marie Bastian
Credential
Provider Entity Type
Individual
Gender
Female
Address
1704 W Main St, Leesburg, FL, 32778-0043
Phone Number
352-702-1478
Fax Number
Provider Enumeration Date
04/06/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1704 W Main St
City
Leesburg
State
Florida
Zip
34748-4861
Phone Number
352-702-1478
Fax Number
person
Provider Business Mailing Address Details
Address
1704 W Main St
City
Leesburg
State
Florida
Zip
34748-4861
Phone Number
352-702-1478
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Developmental Disabilities
Taxonomy
261QD1600X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
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