Individual
JESSICA LANICE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 PECAN RUN, OCALA, FL 34472-1924
(352) 414-9229
Mailing address
30 PECAN RUN, OCALA, FL 34472-1924
(352) 414-9229
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/14/2022
Last updated
02/14/2022
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