Individual
BEVERLY JEAN-JACQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
725 N 12TH AVE BLDG B, ARCADIA, FL 34266-8752
(863) 494-1242
Mailing address
101 RIVERFRONT BLVD STE 710, BRADENTON, FL 34205-8812
(941) 776-4000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY8468
FL
251C00000X
Developmentally Disabled Services Day Training Agency
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Other
Enumeration date
08/06/2007
Last updated
01/19/2023
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