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Individual

JANICE E HERRON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
6767 N WICKHAM RD STE 306, MELBOURNE, FL 32940-2025
(321) 751-1925
Mailing address
6767 N WICKHAM RD STE 306, MELBOURNE, FL 32940-2025
(321) 751-1925

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PY11448
FL
103TF0000X
Family Psychologist
Primary
03722
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
588076
MAMSI
MD
01
NA
NA
Enumeration date
06/09/2005
Last updated
06/22/2022
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