Dennis Mandere
Behavior Technician in Douglasville, GA. Individual provider (NPI-1).
NPI number1982464483
StatusActive
Last updated in NPPESMar 21, 2024
Details
- NPI
- 1982464483
- Entity type
- Individual (NPI-1)
- Name
- Dennis Mandere
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 21, 2024
- Certification date
- Mar 20, 2024
- Last updated
- Mar 21, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
515 Carrington LnDouglasville, GA 30135-6715
Phone 813-390-9768
Mailing address
515 Carrington LnDouglasville, GA 30135-6715
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