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NPI Code Detail

MEDICARE: MRS. ADESUWA JENNIFER JAKPA

MEDICARE: MRS. ADESUWA JENNIFER JAKPA
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 : 1831682590
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ADESUWA JENNIFER JAKPA
Provider Business Mailing Address
First Line : 20619 KEEGANS LEDGE LN
Second Line :
City : CYPRESS
State : TX
Zip : 77433-7723
Country : US
Telephone Number : 346-218-1547
Fax Number :
Provider Business Practice Location Address
First Line : 15703 LONGENBAUGH DR STE H
Second Line :
City : HOUSTON
State : TX
Zip : 77095-1649
Country : US
Telephone Number : 281-258-4447
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2018
Last Update Date : 06/07/2018

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