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1629688163
TANISHA MACK
ORANGE PARK, FL
NPI
1629688163
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2020-08-07
Last Update Date
2020-08-07
Business Address
TANISHA MACK
1563 KINGSLEY AVE STE 103
ORANGE PARK, FL 32073-4503
Phone number: 904-602-9740
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Mailing Address
TANISHA MACK
300 INTERNATIONAL PARKWAY SUITE 200
LAKE MARY, FL 32746-3625
Phone number: 866-610-0580
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