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NPI Code Detail

MEDICARE: JENNIFER BRYANT

MEDICARE: JENNIFER BRYANT
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 : 1194612036
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER BRYANT
Provider Business Mailing Address
First Line : 2900 SPRING FOREST RD STE 101
Second Line :
City : RALEIGH
State : NC
Zip : 27616-1896
Country : US
Telephone Number : 704-780-4271
Fax Number :
Provider Business Practice Location Address
First Line : 2900 SPRING FOREST RD STE 101
Second Line :
City : RALEIGH
State : NC
Zip : 27616-1896
Country : US
Telephone Number : 704-780-4271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2025
Last Update Date : 06/23/2025

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Directions to “ JENNIFER BRYANT ” Practice Location

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