Individual
MRS. JENNINE NOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13139 W LINEBAUGH AVE, TAMPA, FL 33626-4498
(813) 932-3013
Mailing address
13139 W LINEBAUGH AVE, TAMPA, FL 33626-4498
(813) 932-3013
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
N450-436-76-588-0
FL
Other
Enumeration date
05/20/2012
Last updated
05/20/2012
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