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NPI Code Detail

MEDICARE: JESMAILY SANTANA

MEDICARE: JESMAILY SANTANA
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 : 1124824966
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESMAILY SANTANA
Provider Business Mailing Address
First Line : 8200 BALD RIDGE DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28227-0301
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 823 N ELM ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27401-1510
Country : US
Telephone Number : 336-900-1555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2025
Last Update Date : 02/21/2025

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Directions to “ JESMAILY SANTANA ” Practice Location

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