Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Wick

Individual provider Behavior Technician · NPI 1053132001

Ethan Wick is a Behavior Technician in Jacksonville, Florida. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

12724 Gran Bay Pkwy W Ste 410
Jacksonville, FL 32258-9486
Phone: (855) 832-6727
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1053132001
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 22, 2024
Last updated in NPPESOctober 22, 2024
Certification dateOctober 22, 2024
Mailing address7108 S Kanner Hwy, Stuart, FL 34997-7462

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