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Individual

DR. JENNIFER MELAINA SELF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD, PMHNP-BC, LMHC

Contact information

Practice address
28465 US HIGHWAY 19 N, CLEARWATER, FL 33761-2511
(727) 600-8093
(727) 240-0604
Mailing address
8200 BAYSHORE DR APT 1, TREASURE ISLAND, FL 33706-5231
(314) 239-8190

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
17148
FL
101YM0800X
Mental Health Counselor
2002032344
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11017864
FL

Other

Enumeration date
07/22/2011
Last updated
02/03/2022
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