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NPI Code Detail

MEDICARE: JORDAN ROUNTREE-TRAUTH

MEDICARE: JORDAN ROUNTREE-TRAUTH
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 : 1720912116
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN ROUNTREE-TRAUTH
Provider Business Mailing Address
First Line : 311 MARGIE DR
Second Line :
City : WARNER ROBINS
State : GA
Zip : 31088-7818
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 311 MARGIE DR
Second Line :
City : WARNER ROBINS
State : GA
Zip : 31088-7818
Country : US
Telephone Number : 404-224-9346
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2026
Last Update Date : 06/10/2026

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Directions to “ JORDAN ROUNTREE-TRAUTH ” Practice Location

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