Individual
JENNIFER SOUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMT
Contact information
Practice address
30 ROLLING SANDS DRIVE, PALM COAST, FL 32164
(508) 971-0147
Mailing address
355 FAY WAY, MOUNTAIN VIEW, CA 94043-2803
(508) 971-0147
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
729
CA
106H00000X
Marriage & Family Therapist
Primary
83546
CA
106H00000X
Marriage & Family Therapist
PMT175
FL
Other
Enumeration date
03/07/2016
Last updated
04/17/2018
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