Male or Other

Damon R. Countryman

Behavior Technician in Tallahassee, FL(View on Map)

Full Name

Damon Ried Countryman

NPI Number

1043942048

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/28/2022

Specialties

(Taxonomies)

Code

106S00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

300 INTERNATIONAL PKWY STE 200
2868 MAHAN DR # 252627

City

Lake Mary
Tallahassee

State

FL
FL

Postal Code

32746-5028
32308-5468

Country

US
US

Telephone Number

(866) 610-0580
(850) 391-6060

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/28/2022

Provider Address

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