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NPI Code Detail

MEDICARE: JESSICA AMOAKO

MEDICARE: JESSICA AMOAKO
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 : 1477016863
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA AMOAKO
Provider Business Mailing Address
First Line : 27777 INKSTER RD STE 100
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48334-5326
Country : US
Telephone Number : 248-436-4400
Fax Number :
Provider Business Practice Location Address
First Line : 348 SOUTHPORT CIR
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23452-1181
Country : US
Telephone Number : 917-402-5819
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2019
Last Update Date : 11/10/2021

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