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NPI Code Detail

MEDICARE: JESSICA CLODI

MEDICARE: JESSICA CLODI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1770326563
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA CLODI
Provider Business Mailing Address
First Line : 607 N OSCEOLA AVE UNIT A
Second Line :
City : CLEARWATER
State : FL
Zip : 33755-3839
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2912 SW 34TH AVE
Second Line :
City : OCALA
State : FL
Zip : 34474-3364
Country : US
Telephone Number : 813-255-5652
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2024
Last Update Date : 06/18/2024

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Directions to “ JESSICA CLODI ” Practice Location

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