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NPI Code Detail

MEDICARE: JENNIFER ANN BOCKER

MEDICARE: JENNIFER ANN BOCKER
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 : 1508504093
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER ANN BOCKER
Provider Business Mailing Address
First Line : 6416 NW 5TH WAY
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-6112
Country : US
Telephone Number : 888-754-0398
Fax Number :
Provider Business Practice Location Address
First Line : 1000 COLOR PL STE 101
Second Line :
City : APOPKA
State : FL
Zip : 32703-7717
Country : US
Telephone Number : 888-754-0398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2022
Last Update Date : 05/24/2022

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Directions to “ JENNIFER ANN BOCKER ” Practice Location

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