Individual
MS. TWANDA GANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3712 PATINA DR, TAMPA, FL 33619-1252
(813) 455-5550
Mailing address
PO BOX 3690, BRANDON, FL 33509-3690
(813) 526-4213
(813) 450-3642
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/12/2021
Last updated
06/12/2021
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