Flood, Jacquelyn Erlene
Flood, Jacquelyn Erlene is an individual health care provider with primary practice located at 262 Crystal Grove Blvd , Lutz FL 33548-6460. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Flood, Jacquelyn Erlene can be contacted via phone (813) 326-5915.Contact Information
Primary practice address
262 Crystal Grove Blvd
Lutz FL 33548-6460
Phone: (813) 326-5915
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 40267 | Texas |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PY7586 | Florida |
Profile Details
| NPI number | 1548430960 |
|---|---|
| LBN Legal business name | Flood, Jacquelyn Erlene |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 3rd, 2008 |
| Last updated | Oct 25th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548430960 | NPPES |
| Florida | MEDICAID | 768739700 | |
| Florida | Other | 5933D |
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