Provider Demographics
NPI:1053296459
Name:MILESTONES CHILD PSYCHOLOGY
Entity type:Organization
Organization Name:MILESTONES CHILD PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ANNOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:904-615-7504
Mailing Address - Street 1:3204 SAWGRASS VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-5039
Mailing Address - Country:US
Mailing Address - Phone:904-615-7504
Mailing Address - Fax:
Practice Address - Street 1:3204 SAWGRASS VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-5039
Practice Address - Country:US
Practice Address - Phone:904-615-7504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty