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NPI Code Detail

MEDICARE: MS. JESSICA WOODRUFF RBT

MEDICARE: MS. JESSICA WOODRUFF 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
1103K00000XBehavior AnalystRBT-24-371341TN
2106E00000XAssistant Behavior AnalystBACB1159395TN

General Provider Information

NPI Number : 1558153536
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JESSICA WOODRUFF RBT
Provider Business Mailing Address
First Line : 509 SHAWA TRL
Second Line :
City : ANTIOCH
State : TN
Zip : 37013-1837
Country : US
Telephone Number : 760-814-0974
Fax Number :
Provider Business Practice Location Address
First Line : 400 ROYAL PKWY
Second Line :
City : NASHVILLE
State : TN
Zip : 37214-3636
Country : US
Telephone Number : 201-316-5945
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2025
Last Update Date : 05/19/2025

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