Individual
JONTAL FAWCETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3663 CROWN POINT CT, JACKSONVILLE, FL 32257-5967
(904) 288-8910
Mailing address
24 PINDO PALM DR, PONTE VEDRA, FL 32081-6085
(559) 707-4358
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
08/27/2021
Last updated
02/09/2022
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