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NPI Code Detail

MEDICARE: WENDI B JENKINS B.C.B.A

MEDICARE: WENDI B JENKINS B.C.B.A
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
1103K00000XBehavior Analyst0133000073VA

General Provider Information

NPI Number : 1346585478
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDI B JENKINS B.C.B.A
Provider Business Mailing Address
First Line : 336 WHITE OAK DR
Second Line :
City : BLUE RIDGE
State : VA
Zip : 24064-1246
Country : US
Telephone Number : 540-977-1773
Fax Number :
Provider Business Practice Location Address
First Line : 336 WHITE OAK DR
Second Line :
City : BLUE RIDGE
State : VA
Zip : 24064-1246
Country : US
Telephone Number : 540-977-1773
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2012
Last Update Date : 11/29/2012

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