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Individual

AALIYAH MICHELLE EDMOND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1563 KINGSLEY AVE STE 103, ORANGE PARK, FL 32073-4503
(904) 602-9740
Mailing address
7835 LONGHORN CIR E, JACKSONVILLE, FL 32244-7070
(863) 529-7145

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
12/14/2017
Last updated
12/16/2019
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