Provider Demographics
NPI:1659178754
Name:DRUMMOND, RICHANA SHAUNA-LEE
Entity type:Individual
Prefix:
First Name:RICHANA
Middle Name:SHAUNA-LEE
Last Name:DRUMMOND
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14051 BEACH BLVD APT 3319
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32250-1834
Mailing Address - Country:US
Mailing Address - Phone:954-394-2253
Mailing Address - Fax:
Practice Address - Street 1:14051 BEACH BLVD APT 3319
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32250-1834
Practice Address - Country:US
Practice Address - Phone:954-394-2253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician