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NPI Code Detail

MEDICARE: MRS. JACKAVIA DENISE WARTEL

MEDICARE: MRS. JACKAVIA DENISE WARTEL
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
1106E00000XAssistant Behavior Analyst
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1811776891
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JACKAVIA DENISE WARTEL
Provider Business Mailing Address
First Line : 711 N ROCK DR
Second Line :
City : HOUSTON
State : TX
Zip : 77073-5321
Country : US
Telephone Number : 281-736-5316
Fax Number :
Provider Business Practice Location Address
First Line : 1950 ELDRIDGE PKWY
Second Line :
City : HOUSTON
State : TX
Zip : 77077-3448
Country : US
Telephone Number : 281-736-5316
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2023
Last Update Date : 09/27/2023

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