Organization
BUILDING SUCCESSFUL LIVES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE ANDERSON PHD (CLINICAL PSYCHOLOGIST)
(352) 804-2875
Entity
Organization
Contact information
Practice address
2801 SW COLLEGE RD STE 3, OCALA, FL 34474-4430
(352) 804-2875
(352) 390-3868
Mailing address
PO BOX 772345, OCALA, FL 34477-2345
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
02/04/2019
Last updated
10/22/2023
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