Individual
MS. JAMIE RENEE KLEMZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
2309 49TH ST S, GULFPORT, FL 33707-5139
(727) 300-6790
Mailing address
2309 49TH STREET SOUTH, GULFPORT, FL 33707
(727) 300-6790
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
MCAP0101021
FL
106H00000X
Marriage & Family Therapist
Primary
MT2204
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT2204
MFT LICENSURE
FL
Enumeration date
05/14/2007
Last updated
05/14/2024
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