DIANE ROSE WAKEFIELD

PORT ORANGE, FL
NPI1225541063
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy252Y00000X Early Intervention Provider Agency
Additional Taxonomies106S00000X Behavior Technician
Enumeration Date2017-11-15
Last Update Date2019-01-27
Business Address
DIANE ROSE WAKEFIELD
6113 PHEASANT RIDGE DR
PORT ORANGE, FL 32128-6988
Phone number: 386-334-0183
Mailing Address
DIANE ROSE WAKEFIELD
6113 PHEASANT RIDGE DR
PORT ORANGE, FL 32128-6988
Phone number: 386-334-0183
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