Individual
AMANDA GLADSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1611 COBBLER DR, LUTZ, FL 33559-3314
(813) 997-0113
Mailing address
1611 COBBLER DR, LUTZ, FL 33559-3314
(813) 997-0113
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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