Healthcare Provider Details

I. General information

NPI: 1598302259
Provider Name (Legal Business Name): ALISHA GLOVER-CURTIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2019
Last Update Date: 12/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5633 CLIFTON LANE
JACKSONVILLE FL
32211
US

IV. Provider business mailing address

622 FILMORE ST APT 119D
ORANGE PARK FL
32065-8594
US

V. Phone/Fax

Practice location:
  • Phone: 904-503-0131
  • Fax:
Mailing address:
  • Phone: 734-635-4378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: