Jennifer Rennee Jacks
Behavior Technician in Riverview, FL. Individual provider (NPI-1).
NPI number1013679679
StatusActive
Last updated in NPPESOct 12, 2021
Details
- NPI
- 1013679679
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Rennee Jacks
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 12, 2021
- Certification date
- Oct 12, 2021
- Last updated
- Oct 12, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
10817 Bloomingdale AveRiverview, FL 33578-3616
Phone 813-324-1342
Mailing address
4718 Copper Canyon BlvdValrico, FL 33594-9316
Phone 813-409-6612
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All 295 Behavior Technician providers in Riverview · All 2,538 providers in Riverview
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