Doctor Name: | MS. JENNIFER FITZGERALD |
NPI Number: | 1720235583 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S |
License Number: | |
Business Practice Address: | Rr 3 Box 1322 Pahoa, HI - 967787520 |
Business Phone Number: | 8089652036 |
Business Fax Number: | |
Mailing Address: | Rr 3 Box 1322, PAHOA |
State: | HI |
Postal Code: | 967787520 |
Phone Number: | 8089652036 |
Fax Number: | |
NPI Enumeration Date: | 08/24/2008 |
NPI Last Update Date: | 08/24/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |