Jervis Blanding

NPI #1902430325 in Martinez, Georgia

Provider Information

NPI Number: 1902430325
Entity Type: Individual
Name: Jervis Blanding
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Feb 25, 2020
Last Updated: Feb 25, 2020

Practice Location

Address: 3830 WASHINGTON RD
City: Martinez
State: Georgia
ZIP Code: 30907-5064
Phone: (762) 222-7629

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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