Healthcare Provider Details

I. General information

NPI: 1346772829
Provider Name (Legal Business Name): JOCELYN A. LEE, PHD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2653 SW 87TH DR STE A
GAINESVILLE FL
32608-9382
US

IV. Provider business mailing address

2653 SW 87TH DR STE A
GAINESVILLE FL
32608-9382
US

V. Phone/Fax

Practice location:
  • Phone: 352-331-0020
  • Fax: 352-331-0022
Mailing address:
  • Phone: 352-331-0020
  • Fax: 352-331-0022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY8089
License Number StateFL

VIII. Authorized Official

Name: DR. JOCELYN LEE
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 352-331-0020