MEDICARE: JENNIFER EUBANK

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	101YP2500X	Professional Counselor	93593	TX

General Provider Information

NPI Number	:	1356168447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER EUBANK

Provider Business Mailing Address
First Line	:	4300 PUNJAB WAY STE 180
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75033-1272
Country	:	US
Telephone Number	:	214-843-0394
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 PUNJAB WAY STE 180
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75033-1272
Country	:	US
Telephone Number	:	214-606-7523
Fax Number	:

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

Provider Enumeration Date	:	09/20/2024
Last Update Date	:	09/29/2024

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Directions to “ JENNIFER EUBANK ” Practice Location

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