Individual
DR. JACQUELINE FAY JENNETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
1300 PINETREE DR, SUITE 4, INDIAN HARBOUR BEACH, FL 32937-4444
(321) 777-5163
(321) 777-6242
Mailing address
1300 PINETREE DR, SUITE 4, INDIAN HARBOUR BEACH, FL 32937-4444
(321) 777-5163
(321) 777-6242
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY3690
FL
Other
Enumeration date
07/09/2006
Last updated
07/08/2007
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