Most Relevant Information
Provider Data
| NPI Number: | 1003430158 |
| Provider Name: | JORDYN VANVAKAS |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/04/2020 |
| Last Updated: | 06/04/2020 |
Provider Practice Location
10909 MEMORIAL HWY
TAMPA
FL
336152511
Practice Location Phone/Fax
| Phone: | 8138554435 |
| Fax: |
Provider Mailing Location
307 COVENTRY RD
DAVENPORT
FL
338973894
Provider Mailing Phone/Fax
| Phone: | 8638002702 |
| Fax: |