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NPI Code Detail

MEDICARE: MS. JENNIFER ALICIA WELLS

MEDICARE: MS. JENNIFER ALICIA WELLS
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 : 1609735273
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER ALICIA WELLS
Provider Business Mailing Address
First Line : 29 DEL A RAE CIR
Second Line :
City : GUYTON
State : GA
Zip : 31312-4111
Country : US
Telephone Number : 912-678-2859
Fax Number :
Provider Business Practice Location Address
First Line : 100 COMMERCE CT
Second Line :
City : POOLER
State : GA
Zip : 31322-9445
Country : US
Telephone Number : 615-560-6622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2026
Last Update Date : 01/20/2026

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Directions to “ MS. JENNIFER ALICIA WELLS ” Practice Location

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