Individual
MRS. JENNIFER STAPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
3763 EVANS AVE, FORT MYERS, FL 33901
(239) 332-6937
(239) 332-0287
Mailing address
3763 EVANS AVE, FORT MYERS, FL 33901-9302
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
FL
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025039400
—
FL
Enumeration date
07/17/2013
Last updated
03/22/2023
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