Individual
JACQUELINE L BLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4601 PONCE DE LEON BLVD, SUITE 380, CORAL GABLES, FL 33146-2111
(305) 992-3397
Mailing address
7700 SW 122ND ST, MIAMI, FL 33156-5225
(305) 992-3397
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 8407
FL
Other
Enumeration date
11/01/2012
Last updated
11/01/2012
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