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NPI Code Detail

MEDICARE: JENNIE LAING RBT

MEDICARE:   JENNIE  LAING  RBT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1043727795
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIE LAING RBT
Provider Business Mailing Address
First Line : 3504 MOUNT OLNEY LN
Second Line :
City : OLNEY
State : MD
Zip : 20832-1116
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3504 MOUNT OLNEY LN
Second Line :
City : OLNEY
State : MD
Zip : 20832-1116
Country : US
Telephone Number : 301-928-9559
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2018
Last Update Date : 01/03/2018

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Directions to “ JENNIE LAING RBT” Practice Location

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