Individual
JANOLYN S GREGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2625 WESTON RD, WESTON, FL 33331-3614
(954) 385-0353
(954) 385-0353
Mailing address
2625 WESTON RD, WESTON, FL 33331-3614
(954) 385-0353
(954) 385-0353
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PY4483
FL
103TB0200X
Cognitive & Behavioral Psychologist
PY4483
FL
103TC0700X
Clinical Psychologist
Primary
PY4483
FL
103TC2200X
Clinical Child & Adolescent Psychologist
PY4483
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407064462
FIRST COAST SERVICE OPTIONS, INC.
FL
01
—
59332
BCBSFL
FL
Enumeration date
12/28/2006
Last updated
06/16/2018
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