Divine Gann
Behavior Technician in Jacksonville, FL. Individual provider (NPI-1).
NPI number1164078317
StatusActive
Last updated in NPPESAug 14, 2019
Details
- NPI
- 1164078317
- Entity type
- Individual (NPI-1)
- Name
- Divine Gann
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 14, 2019
- Last updated
- Aug 14, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
6859 Belfort Oaks PlJacksonville, FL 32216-6242
Phone 800-356-4049
Mailing address
6859 Belfort Oaks PlJacksonville, FL 32216-6242
Phone 800-356-4049
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