Jessica Elizabeth Broyles

Individual provider Active NPI Behavior Technician · Decatur, TN

NPI 1831959147 · NPPES record last updated Mar 22, 2024

Key facts

NPI
1831959147
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1102 Ford Rd
Decatur, TN 37322-7680
Phone
(423) 506-4781
NPI assigned
Mar 21, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician
Group: 193400000X SINGLE SPECIALTY GROUP
106S00000X Yes

Addresses

Primary practice location

1102 Ford Rd
Decatur, TN 37322-7680

Mailing address

7108 S Kanner Hwy
Stuart, FL 34997-7462

Other providers in Decatur, TN

All providers in Decatur, TN · Behavior Technician in Tennessee

Sources for this page

Verify at the official NPI Registry.