Healthcare Provider Details

I. General information

NPI: 1952236697
Provider Name (Legal Business Name): FUTURE SCHOLARS PEDIATRIC DEVELOPMENT CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1197 NOE BIXBY RD
COLUMBUS OH
43213-3530
US

IV. Provider business mailing address

2046 HAVENSWOOD PL
BLACKLICK OH
43004-8513
US

V. Phone/Fax

Practice location:
  • Phone: 614-483-9192
  • Fax:
Mailing address:
  • Phone: 614-483-9192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MRS. JANGELIQUE BODDIE
Title or Position: MANAGING MEMBER&CEO
Credential:
Phone: 614-483-9192