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General NPI Number Information
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NPI Number | 1831873926
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Entity Type | Individual
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Provider Name | DEMETRIA ASHANEY MCCARVER
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Gender | Female
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Dates
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Enumeration Date | 06/09/2023
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Last Update Date | 06/09/2023
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Provider Practice Location Address
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Address Line | 12735 GRAN BAY PKWY W STE 204
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City | JACKSONVILLE
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State | FL
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Zip | 32258-4499
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Country | US
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Telephone | 877-897-0743
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Fax |
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Provider Business Mailing Address
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Address Line | 6017 ROOSEVELT BLVD APT 121
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City | JACKSONVILLE
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State | FL
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Zip | 32244-3317
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Country | US
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Telephone | 904-631-0640
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Fax |
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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 | 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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