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General NPI Number Information
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NPI Number | 1124497441
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Entity Type | Individual
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Provider Name | JACLYN REBECCA LEVINE
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Gender | Female
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Dates
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Enumeration Date | 09/16/2015
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 14940 SW 53RD LN
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City | MIAMI
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State | FL
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Zip | 33185-4024
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Country | US
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Telephone | 305-322-5889
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Fax | 305-901-1797
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Provider Business Mailing Address
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Address Line | 11720 BELTSVILLE DR # 500A15
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City | BELTSVILLE
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State | MD
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Zip | 20705-3166
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Country | US
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Telephone | 305-322-5889
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Fax | 305-901-1797
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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