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General NPI Number Information
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NPI Number | 1114066461
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Entity Type | Individual
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Provider Name | JACQUELINE B PEPPER PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 09/13/2016
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Provider Practice Location Address
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Address Line | 1515 N UNIVERSITY DR SUITE 202
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-6096
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Country | US
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Telephone | 954-345-2292
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Fax | 954-341-8101
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Provider Business Mailing Address
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Address Line | 1515 N UNIVERSITY DR STE 203
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8919
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Country | US
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Telephone | 954-345-2292
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Fax | 954-341-8101
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY6102
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License Number State | FL
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