Hidalgo, Jacqueline Stephanie
Hidalgo, Jacqueline Stephanie is an sole proprietor health care provider with primary practice located at 2780 Cleveland Ave Ste 709 , Fort Myers FL 33901-5857. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Hidalgo, Jacqueline Stephanie can be contacted via phone (239) 343-3831.Contact Information
Primary practice address
2780 Cleveland Ave Ste 709
Fort Myers FL 33901-5857
Phone: (239) 343-3831
Fax: (239) 343-2301
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PY9966 | Florida |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PY9966 | Florida |
Profile Details
| NPI number | 1952828832 |
|---|---|
| LBN Legal business name | Hidalgo, Jacqueline Stephanie |
| Credentials | PSY-D |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 23rd, 2017 |
| Last updated | Mar 25th, 2021 - about 5 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 | 1952828832 | NPPES |
| Florida | MEDICAID | 100459600 |
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