Individual
JACK ARTHUR PEVERILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2163 SOUTH TAMIAMI TRAIL, OSPREY, FL 34229-9696
(941) 924-6113
(941) 924-6113
Mailing address
4724 ACORN CIRCLE, SARASOTA, FL 34233-3935
(941) 924-6113
(941) 924-6113
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PY 3601
FL
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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