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3402 Parson Ct Jacksonville FL 32223-7337 | |
| (904) 434-0785 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3402 Parson Ct, Jacksonville, Florida |
| Authorized Official Name and Position | Helena Danea Jenkins (OWNER) |
| Authorized Official Contact | 9044340785 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3402 Parson Ct Fl 32223 Jacksonville FL 32223-7337 Ph: (904) 323-1782 | 3402 Parson Ct Jacksonville FL 32223-7337 Ph: (904) 434-0785 |
| NPI Number | 1821619438 |
|---|---|
| Provider Enumeration Date | 05/05/2020 |
| Last Update Date | 06/21/2024 |
| Certification Date | 06/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821619438 | NPI | - | NPPES |
| 1245735711 | Medicaid | FL | |
| 1821619438 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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