Individual
MRS. ANASUYA BANERJEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ITDS
Contact information
Practice address
4308 HANOVER PARK DR, JACKSONVILLE, FL 32224-8602
(904) 504-5086
Mailing address
4308 HANOVER PARK DR, JACKSONVILLE, FL 32224-8602
(904) 504-5086
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001542400
—
FL
Enumeration date
10/17/2009
Last updated
05/28/2013
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