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Individual

ADDISON GILLIGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
13424 FORT KING RD, DADE CITY, FL 33525-5214
(352) 437-3559
Mailing address
1510 ATAMI CT, WESLEY CHAPEL, FL 33544-6845
(352) 727-1290

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-360152
FL

Other

Enumeration date
07/10/2024
Last updated
07/10/2024
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