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NPI Code Detail

MEDICARE: JESSICA BUTTERS

MEDICARE: JESSICA BUTTERS
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 AnalystB362433927870FL
2106S00000XBehavior TechnicianRBT-18-59983FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124440144
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA BUTTERS
Provider Business Mailing Address
First Line : 20833 NW 41ST AVENUE RD
Second Line :
City : MIAMI GARDENS
State : FL
Zip : 33055-1370
Country : US
Telephone Number : 786-317-4478
Fax Number :
Provider Business Practice Location Address
First Line : 12051 W OKEECHOBEE RD
Second Line :
City : HIALEAH GARDENS
State : FL
Zip : 33018-2933
Country : US
Telephone Number : 305-828-5276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2014
Last Update Date : 06/07/2019

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Directions to “ JESSICA BUTTERS ” Practice Location

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