Most Relevant Information
Provider Data
| NPI Number: | 1003459413 |
| Provider Name: | JENNIFER MARIE GARTLAND |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/18/2019 |
| Last Updated: | 10/18/2019 |
Provider Practice Location
111 NEWMAN ST
EAST TAWAS
MI
487301272
Practice Location Phone/Fax
| Phone: | 9899840066 |
| Fax: |
Provider Mailing Location
111 NEWMAN ST
EAST TAWAS
MI
487301272
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |