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NPI Code Detail

MEDICARE: KENYETTA POPE

MEDICARE: KENYETTA POPE
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 : 1306797485
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENYETTA POPE
Provider Business Mailing Address
First Line : 3600 ROUTE 66 STE 150
Second Line :
City : NEPTUNE
State : NJ
Zip : 07753-2645
Country : US
Telephone Number : 410-609-6357
Fax Number :
Provider Business Practice Location Address
First Line : 9711 WASHINGTONIAN BLVD STE 550
Second Line :
City : GAITHERSBURG
State : MD
Zip : 20878-5789
Country : US
Telephone Number : 410-609-6357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2026
Last Update Date : 02/05/2026

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Directions to “ KENYETTA POPE ” Practice Location

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