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Nasasha Sports

Behavior Technician in Lakeland, FL. Individual provider (NPI-1).

NPI number1356830392
StatusActive
Last updated in NPPESMay 4, 2018

Details

NPI
1356830392
Entity type
Individual (NPI-1)
Name
Nasasha Sports
Sex
Female
Sole proprietor
Yes
Enumeration date
May 4, 2018
Last updated
May 4, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior TechnicianA61789270VAYes

Practice location

145 E Edgewood Dr
Lakeland, FL 33803-4014

Phone 863-619-2809

Mailing address

12819 Daybreak Cir
Newport News, VA 23602-9518

Phone 757-696-2018

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