Bennett-Bradshaw, Jodi

Bennett-Bradshaw, Jodi is an individual health care provider with primary practice located at 418B W Mountain St , Kernersville NC 27284-2534. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Bennett-Bradshaw, Jodi can be contacted via phone (704) 780-4271.

Contact Information

Primary practice address
418B W Mountain St Kernersville NC 27284-2534
Phone: (704) 780-4271
Fax: (704) 788-2016
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1669073359
LBN Legal business name Bennett-Bradshaw, Jodi
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2020
Last updated Nov 8th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669073359 NPPES
North Carolina Other 11991928 DRIVERS LICENSE

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