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NPI Code Detail

MEDICARE: JENNA JASO

MEDICARE: JENNA JASO
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
2235Z00000XSpeech-Language Pathologist230060AL

General Provider Information

NPI Number : 1780208702
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA JASO
Provider Business Mailing Address
First Line : 519 AVENIDA CESAR E CHAVEZ
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-2133
Country : US
Telephone Number :
Fax Number : 615-577-5654
Provider Business Practice Location Address
First Line : 519 AVENIDA CESAR E CHAVEZ
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-2133
Country : US
Telephone Number : 888-913-1910
Fax Number : 615-577-5654
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2020
Last Update Date : 04/09/2024

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Directions to “ JENNA JASO ” Practice Location

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