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NPI Code Detail

MEDICARE: JAYDEN N JOSEPH

MEDICARE: JAYDEN N JOSEPH
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 TechnicianRBT-19-85540TX

General Provider Information

NPI Number : 1043829039
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAYDEN N JOSEPH
Provider Business Mailing Address
First Line : 24124 CINCO VILLAGE CENTER BLVD STE 200
Second Line :
City : KATY
State : TX
Zip : 77494-8389
Country : US
Telephone Number : 832-263-6634
Fax Number :
Provider Business Practice Location Address
First Line : 24124 CINCO VILLAGE CENTER BLVD STE 200
Second Line :
City : KATY
State : TX
Zip : 77494-8389
Country : US
Telephone Number : 832-263-6634
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2020
Last Update Date : 07/27/2020

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Directions to “ JAYDEN N JOSEPH ” Practice Location

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