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NPI Code Detail

MEDICARE: JESSICA MILBOURN

MEDICARE:   JESSICA  MILBOURN
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
1106E00000XAssistant Behavior Analyst
2103K00000XBehavior AnalystFL

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 : 1205552064
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MILBOURN
Provider Business Mailing Address
First Line : 2100 NURSERY RD APT H20
Second Line :
City : CLEARWATER
State : FL
Zip : 33764-2651
Country : US
Telephone Number : 815-585-5495
Fax Number :
Provider Business Practice Location Address
First Line : 3375 34TH ST N STE 206
Second Line :
City : SAINT PETERSBURG
State : FL
Zip : 33713-2400
Country : US
Telephone Number : 727-643-0011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2022
Last Update Date : 11/26/2024

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Directions to “ JESSICA MILBOURN ” Practice Location

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