(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003479726
Provider Name: NICHOLE BASHARA RBT19-80867
Entity Type: Individual
Taxonomy Code: 106S00000X
Specialty: Behavior Technician
License Number: 19-80867
Most Important Dates
Enumeration Date: 04/18/2019
Last Updated: 08/30/2024
Provider Practice Location
8382 BAYMEADOWS RD
JACKSONVILLE
FL
322564447
Practice Location Phone/Fax
Phone: 9044667186
Fax:
Provider Mailing Location
1264 NIPIGON AVE S
JACKSONVILLE
FL
322332226
Provider Mailing Phone/Fax
Phone:
Fax: