Most Relevant Information
Provider Data
| NPI Number: | 1003575861 |
| Provider Name: | DEJANEL L MCKINNIE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | BACB730187 |
Most Important Dates
| Enumeration Date: | 12/09/2021 |
| Last Updated: | 12/09/2021 |
Provider Practice Location
8001 BEATY GROVE DR
TAMPA
FL
336261602
Practice Location Phone/Fax
| Phone: | 8139265454 |
| Fax: |
Provider Mailing Location
1338 JAMBALANA DR
HOLIDAY
FL
346916748
Provider Mailing Phone/Fax
| Phone: | 7793024360 |
| Fax: |