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NPI Code Detail

MEDICARE: JENNIFER L DEIEN M.S., BCBA

MEDICARE: JENNIFER L DEIEN M.S., BCBA
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 Analyst
2103K00000XBehavior Analyst1-09-5653

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669795829
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER L DEIEN M.S., BCBA
Provider Business Mailing Address
First Line : 550 N REO ST
Second Line : SUITE 202
City : TAMPA
State : FL
Zip : 33609-1061
Country : US
Telephone Number : 813-374-2070
Fax Number :
Provider Business Practice Location Address
First Line : 1413 TECH BLVD STE 122
Second Line :
City : TAMPA
State : FL
Zip : 33619-7822
Country : US
Telephone Number : 855-832-6727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2010
Last Update Date : 04/20/2021

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