Individual
MS. DEBORAH JERVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11120 S CROWN WAY STE 1, WELLINGTON, FL 33414-8718
(352) 256-2877
Mailing address
1568 COASTAL OAKS CIR W, FERNANDINA BEACH, FL 32034-3273
(352) 256-2877
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW6162
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z039U
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/16/2007
Last updated
02/08/2020
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