Doctor Name: | DR. JESSICA L. VERA |
NPI Number: | 1003919424 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | MH8093 |
Business Practice Address: | 1060 Oysterwood St Hollywood, FL - 33019 |
Business Phone Number: | 9546650319 |
Business Fax Number: | 9543676650 |
Mailing Address: | 1060 Oysterwood St, Suite 112 HOLLYWOOD |
State: | FL |
Postal Code: | 330194848 |
Phone Number: | 9546650319 |
Fax Number: | |
NPI Enumeration Date: | 09/07/2006 |
NPI Last Update Date: | 04/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH8093 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |