JENNA GRACE MALLEK CAMPOS


Address: 13626 Phoenix Dr, Orlando, FL 32828-9338
Phone: 4079259104

JENNA GRACE MALLEK CAMPOS (NPI# 1407457161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407457161
Entity Type Individual
Full Name JENNA GRACE MALLEK CAMPOS
Other Name JENNA GRACE MALLEK
Practice Address 13626 Phoenix Dr
Orlando
FL 32828-9338
Practice Telephone 4079259104
Mailing Telephone 4079259104
Enumeration Date 2020-11-07
Last Update Date 2020-11-07
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
Behavioral Health & Social Service Providers

Office Location

Street Address 13626 PHOENIX DR
City ORLANDO
State FL
Zip Code 32828-9338

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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City ORLANDO
Zip Code 32828

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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