Individual
MR. GORDON MANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11445 CAMBRAY CREEK LOOP, RIVERVIEW, FL 33579-3925
(813) 727-0509
Mailing address
11445 CAMBRAY CREEK LOOP, RIVERVIEW, FL 33579-3925
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-19-9721
FL
Other
Enumeration date
04/30/2013
Last updated
11/17/2019
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