Most Relevant Information
Provider Data
| NPI Number: | 1003353541 |
| Provider Name: | JENNIE LORD |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/23/2017 |
| Last Updated: | 01/23/2017 |
Provider Practice Location
8700 ROLLING BROOK LN
JACKSONVILLE
FL
322569024
Practice Location Phone/Fax
| Phone: | 3522846057 |
| Fax: |
Provider Mailing Location
8700 ROLLING BROOK LN
JACKSONVILLE
FL
322569024
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |