MEDICARE: MS. JENNIFER C DARDEN

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
1	106S00000X	Behavior Technician	BACB1052822	AZ

General Provider Information

NPI Number	:	1275398125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER C DARDEN

Provider Business Mailing Address
First Line	:	2510 E MEADOW LAND DR
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85140-5632
Country	:	US
Telephone Number	:	520-431-3338
Fax Number	:

Provider Business Practice Location Address
First Line	:	4240 S ARIZONA AVE STE 1039
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85248-4593
Country	:	US
Telephone Number	:	602-935-9185
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2024
Last Update Date	:	02/20/2024

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Directions to “ MS. JENNIFER C DARDEN ” Practice Location

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