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NPI Code Detail

MEDICARE: JESSICA BARRETT

MEDICARE: JESSICA BARRETT
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 Analyst11622836NV

General Provider Information

NPI Number : 1750883013
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA BARRETT
Provider Business Mailing Address
First Line : 1707 VILLAGE CENTER CIR STE 140
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-0577
Country : US
Telephone Number : 702-766-9840
Fax Number :
Provider Business Practice Location Address
First Line : 1707 VILLAGE CENTER CIR STE 140
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-0577
Country : US
Telephone Number : 702-766-9840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2018
Last Update Date : 05/16/2022

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Directions to “ JESSICA BARRETT ” Practice Location

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