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NPI Code Detail

MEDICARE: JAELYN WILSON RBT

MEDICARE: JAELYN WILSON RBT
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

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 : 1326721614
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAELYN WILSON RBT
Provider Business Mailing Address
First Line : PO BOX 10827
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32302-2827
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2928 WELLINGTON CIR STE 201
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32309-6879
Country : US
Telephone Number : 850-521-0242
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2023
Last Update Date : 01/14/2026

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