Organization
JACKIE TWITCHELL, PSY.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACKIE A TWITCHELL PSY.D. (PRESIDENT)
(239) 275-9353
Entity
Organization
Contact information
Practice address
8192 COLLEGE PKWY, BLDG A, STE 21, FORT MYERS, FL 33919-5175
(239) 275-9353
(239) 466-3390
Mailing address
8192 COLLEGE PKWY, BLDG A, STE 21, FORT MYERS, FL 33919-5175
(239) 275-9353
(239) 466-3390
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY5030
FL
Other
Enumeration date
10/31/2010
Last updated
12/02/2010
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