Provider Demographics
NPI:1134321664
Name:LIGHTNER, JHARMAN (MS,ITDS)
Entity Type:Individual
Prefix:
First Name:JHARMAN
Middle Name:
Last Name:LIGHTNER
Suffix:
Gender:F
Credentials:MS,ITDS
Other - Prefix:
Other - First Name:JHARMAN
Other - Middle Name:
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, ITDS
Mailing Address - Street 1:PO BOX 65516
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-0009
Mailing Address - Country:US
Mailing Address - Phone:904-595-6516
Mailing Address - Fax:
Practice Address - Street 1:531 W UNION ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32202-4047
Practice Address - Country:US
Practice Address - Phone:904-595-6516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No252Y00000XAgenciesEarly Intervention Provider Agency