Debastiani, Jennifer

Debastiani, Jennifer is an individual health care provider with primary practice located at 102 Elizabeth St Suite C, Jacksonville NC 28540-5676. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Debastiani, Jennifer can be contacted via phone (910) 333-0814.

Contact Information

Primary practice address
102 Elizabeth St Suite C Jacksonville NC 28540-5676
Phone: (910) 333-0814
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1639615388
LBN Legal business name Debastiani, Jennifer
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2017
Last updated Jan 18th, 2017 - about 9 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 1639615388 NPPES
Massachusetts MEDICAID 110026265E

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