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NPI Code Detail

MEDICARE: JESSICA SPILL

MEDICARE: JESSICA SPILL
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 : 1518526086
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA SPILL
Provider Business Mailing Address
First Line : 2651 NE 18TH ST
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33062-3014
Country : US
Telephone Number : 954-732-2586
Fax Number :
Provider Business Practice Location Address
First Line : 1000 NW 65TH ST STE 201
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-1113
Country : US
Telephone Number : 855-832-6727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2019
Last Update Date : 06/10/2019

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Directions to “ JESSICA SPILL ” Practice Location

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