Individual
JESSICA S DUGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ITDS
Contact information
Practice address
4813 INNISBROOK CT S, ELKTON, FL 32033-2067
(904) 874-2661
Mailing address
4813 INNISBROOK CT S, ELKTON, FL 32033-2067
(904) 874-2661
(904) 825-2626
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
888731100
FL
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8117420 00
—
FL
Enumeration date
01/22/2007
Last updated
03/11/2025
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