Jennifer Jack

NPI #1386182368 in Covington, Virginia

Provider Information

NPI Number: 1386182368
Entity Type: Individual
Name: Jennifer Jack
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Feb 9, 2017
Last Updated: Feb 9, 2017

Practice Location

Address: 729 N GREENBRIER AVE
City: Covington
State: Virginia
ZIP Code: 24426-1319
Phone: (540) 691-9655

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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