Individual
DR. JACQUELINE KATHLEEN CLARKE JEMMOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
7203 PINE FOREST RD, PENSACOLA, FL 32526
(954) 274-0507
Mailing address
PO BOX 835, CANTONMENT, FL 32533-0835
(954) 274-0507
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
MCAP010627
FL
101YM0800X
Mental Health Counselor
MT2821
FL
106H00000X
Marriage & Family Therapist
Primary
MT2821
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760733398
—
FL
Enumeration date
09/22/2012
Last updated
08/28/2018
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