Individual
JENNA HARLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17506 BRIGHT WHEAT DR, LITHIA, FL 33547-4331
(217) 836-6627
Mailing address
17506 BRIGHT WHEAT DR, LITHIA, FL 33547-4331
(217) 836-6627
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
10/19/2016
Last updated
04/21/2022
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