Individual
GENESIS DUPRISTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3771 SAN JOSE PL, SUITE 22, JACKSONVILLE, FL 32257
(904) 928-0112
Mailing address
2893 SYDNEY ST, APT 1, JACKSONVILLE, FL 32205-8040
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
02/26/2014
Last updated
05/31/2018
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