Individual
MS. JERI DEVALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
6241 43RD TER N, KENNETH CITY, FL 33709
(727) 374-3092
(727) 374-9819
Mailing address
6241 43RD TER N, KENNETH CITY, FL 33709
(727) 374-3092
(727) 374-9819
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MT1779
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT1779
MFCT DEP. OF HEALTH
FL
Enumeration date
04/25/2012
Last updated
04/25/2012
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