Individual
JENNIFER BANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2040 HIGHWAY A1A, SUITE 203, INDIAN HARBOUR BEACH, FL 32937-3566
(321) 773-8989
Mailing address
2040 HIGHWAY A1A, SUITE 203, INDIAN HARBOUR BEACH, FL 32937-3566
(321) 773-8989
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 15510
FL
Other
Enumeration date
04/11/2017
Last updated
04/11/2017
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