Duclos, Jennifer

Duclos, Jennifer is an individual health care provider with primary practice located at 5175 Old Clemmons School Road , Winston-Salem NC 27102-4020. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Duclos, Jennifer can be contacted via phone (704) 780-4271.

Contact Information

Primary practice address
5175 Old Clemmons School Road Winston-Salem NC 27102-4020
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
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1306376157
LBN Legal business name Duclos, Jennifer
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2017
Last updated Sep 23rd, 2021 - 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 1306376157 NPPES
Florida MEDICAID 021564700

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