Provider Demographics
NPI:1396329066
Name:TOGNARELLI, MEGNON MCLEMORE (RBT)
Entity type:Individual
Prefix:
First Name:MEGNON
Middle Name:MCLEMORE
Last Name:TOGNARELLI
Suffix:
Gender:F
Credentials:RBT
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Other - Middle Name:
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Mailing Address - Street 1:10175 FORTUNE PKWY UNIT 903
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6755
Mailing Address - Country:US
Mailing Address - Phone:904-538-0713
Mailing Address - Fax:904-538-0714
Practice Address - Street 1:225 MILLARD FARMER IND BLVD BLDG 100
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-3168
Practice Address - Country:US
Practice Address - Phone:470-400-3177
Practice Address - Fax:904-538-0714
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
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Provider Licenses
StateLicense IDTaxonomies
GA21-167105106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician