Individual
MS. RANDI L KLAIRE-JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, ATR
Contact information
Practice address
537 SW DAUPHIN AVE, PORT ST LUCIE, FL 34953-5854
(423) 341-3356
Mailing address
537 SW DAUPHIN AVE, PORT ST LUCIE, FL 34953-5854
(423) 341-3356
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
86-069
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K462-732-55-629-0
DRIVERS LICENSE
FL
Enumeration date
09/28/2022
Last updated
09/28/2022
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