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NPI Code Detail

MEDICARE: CHRISTIAN LYNN WELLS

MEDICARE:   CHRISTIAN LYNN WELLS
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 : 1508479254
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN LYNN WELLS
Provider Business Mailing Address
First Line : 3901 BATTLEGROUND AVE APT 101
Second Line :
City : GREENSBORO
State : NC
Zip : 27410-9461
Country : US
Telephone Number : 786-236-9327
Fax Number :
Provider Business Practice Location Address
First Line : 3901 BATTLEGROUND AVE APT 101
Second Line :
City : GREENSBORO
State : NC
Zip : 27410-9461
Country : US
Telephone Number : 786-236-9327
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2020
Last Update Date : 08/24/2020

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Directions to “ CHRISTIAN LYNN WELLS ” Practice Location

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