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NPI Code Detail

MEDICARE: SARAH JENKS BCABA

MEDICARE: SARAH JENKS BCABA
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

General Provider Information

NPI Number : 1891044020
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH JENKS BCABA
Provider Business Mailing Address
First Line : 4100 PRICE CLUB BLVD
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23112-3379
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4100 PRICE CLUB BLVD
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23112-3379
Country : US
Telephone Number : 804-674-8888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2012
Last Update Date : 03/25/2014

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Directions to “ SARAH JENKS BCABA” Practice Location

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