Individual ProviderDaejah VicenteBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address6100 Veterans Pkwy Ste 11, Columbus, GA 31909-3514(813) 438-6796PECOS EnrollmentBased on the most recent information from CMS, provider Daejah Vicente does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1013896141Provider TypeIndividualFull NameVicente, DaejahGenderFemaleSole ProprietorNoEnumeration Date9/2/2025Last Updated9/2/2025Contact InformationPractice LocationPractice Address6100 Veterans Pkwy Ste 11, Columbus, GA 31909-3514Phone(813) 438-6796FaxUnlisted FaxMailing LocationMailing Address1202 Tech Blvd Ste 104, Tampa, FL 33619-7863PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerGeorgia