Individual
ALEXANDER GENDREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6196 LAKE GRAY BLVD STE 116, JACKSONVILLE, FL 32244-5867
(800) 356-4049
(941) 485-0519
Mailing address
5 REVERE DR STE 120, NORTHBROOK, IL 60062-8005
(800) 356-4049
(941) 485-0519
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-135673
FL
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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