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General NPI Number Information
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NPI Number | 1588305346
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Entity Type | Individual
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Provider Name | BRYANA DEJOIE
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Gender | Female
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 12276 SAN JOSE BLVD STE 21
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City | JACKSONVILLE
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State | FL
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Zip | 32223-8628
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Country | US
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Telephone | 904-830-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 959 17TH ST STE B
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City | COLUMBUS
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State | GA
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Zip | 31901-1984
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Country | US
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Telephone |
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Fax | 706-780-1705
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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