Provider Demographics
NPI:1528591856
Name:RINCONES, JENNIFER LEYLA (BS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEYLA
Last Name:RINCONES
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17118 HIGDON DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48193-1709
Mailing Address - Country:US
Mailing Address - Phone:313-492-4558
Mailing Address - Fax:
Practice Address - Street 1:17118 HIGDON DR
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:MI
Practice Address - Zip Code:48193-1709
Practice Address - Country:US
Practice Address - Phone:313-492-4558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator