MEDICARE: JENNIFER ROOK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	005320	NY

General Provider Information

NPI Number	:	1891050639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ROOK

Provider Business Mailing Address
First Line	:	2147 FAIRWAY VILLAS DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32233-0015
Country	:	US
Telephone Number	:	716-715-7781
Fax Number	:

Provider Business Practice Location Address
First Line	:	2147 FAIRWAY VILLAS DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32233-0015
Country	:	US
Telephone Number	:	716-715-7781
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2012
Last Update Date	:	09/29/2023

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Directions to “ JENNIFER ROOK ” Practice Location

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