Healthcare Provider Details

I. General information

NPI: 1841654282
Provider Name (Legal Business Name): JENNIFER SAGER, PH.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2016
Last Update Date: 04/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 NW 6TH ST
GAINESVILLE FL
32601-4245
US

IV. Provider business mailing address

1208 NW 6TH ST
GAINESVILLE FL
32601-4245
US

V. Phone/Fax

Practice location:
  • Phone: 352-379-2829
  • Fax: 352-379-2843
Mailing address:
  • Phone: 352-379-2829
  • Fax: 352-379-2843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY7422
License Number StateFL

VIII. Authorized Official

Name: JENNIFER SAGER
Title or Position: OWNER
Credential: PH.D.
Phone: 352-379-2829