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NPI Code Detail

MEDICARE: JESSICA LYNN WINEBRENNER

MEDICARE: JESSICA LYNN WINEBRENNER
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
2103K00000XBehavior Analyst1-23-66727MD

General Provider Information

NPI Number : 1154986388
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA LYNN WINEBRENNER
Provider Business Mailing Address
First Line : 1401 SUMMER SWEET LN
Second Line :
City : MOUNT AIRY
State : MD
Zip : 21771-5576
Country : US
Telephone Number : 301-706-1454
Fax Number :
Provider Business Practice Location Address
First Line : 5310 SPECTRUM DR
Second Line :
City : FREDERICK
State : MD
Zip : 21703-7362
Country : US
Telephone Number : 301-337-8833
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2019
Last Update Date : 12/01/2023

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Directions to “ JESSICA LYNN WINEBRENNER ” Practice Location

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