Individual
JACKIE SUZANNE BRANDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 GOVERNORS TRCE STE 101, PEACHTREE CITY, GA 30269-4853
(770) 268-2798
Mailing address
300 INTERNATIONAL PKWY, LAKE MARY, FL 32746-5035
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/20/2020
Last updated
06/20/2020
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