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NPI Code Detail

MEDICARE: ROBIN JERVIS

MEDICARE: ROBIN JERVIS
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 : 1003545047
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBIN JERVIS
Provider Business Mailing Address
First Line : 3015 MARKET ST
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-0724
Country : US
Telephone Number : 910-554-3081
Fax Number :
Provider Business Practice Location Address
First Line : 3015 MARKET ST
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-0724
Country : US
Telephone Number : 910-554-3081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2022
Last Update Date : 11/05/2025

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Directions to “ ROBIN JERVIS ” Practice Location

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