Provider Demographics
NPI:1447879044
Name:JAHANBIN, BRITINI NICOLE
Entity type:Individual
Prefix:
First Name:BRITINI
Middle Name:NICOLE
Last Name:JAHANBIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2476 CHERRY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-7740
Mailing Address - Country:US
Mailing Address - Phone:575-446-2373
Mailing Address - Fax:
Practice Address - Street 1:2476 CHERRY HILLS DR
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-7740
Practice Address - Country:US
Practice Address - Phone:575-446-2373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-14
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician