Healthcare Provider Details

I. General information

NPI: 1083526511
Provider Name (Legal Business Name): NURTURED TO GROW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

272 WHISPER RIDGE DR
SAINT AUGUSTINE FL
32092-3783
US

IV. Provider business mailing address

272 WHISPER RIDGE DR
SAINT AUGUSTINE FL
32092-3783
US

V. Phone/Fax

Practice location:
  • Phone: 904-417-7428
  • Fax:
Mailing address:
  • Phone: 904-417-7428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: EILEEN MATEU
Title or Position: SCHOOL PSYCHOLOGIST
Credential:
Phone: 386-490-3313