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NPI 1205113610

NPI 1205113610 : JAIME LA FARR JENKINS PH.D., LMHC, NCC : GAINESVILLE, FL

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General NPI Number Information
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    NPI Number           |    1205113610
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    Entity Type          |    Individual 
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    Provider Name        |    JAIME LA FARR JENKINS PH.D., LMHC, NCC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/14/2011
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    Last Update Date     |    11/14/2011
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Provider Practice Location Address
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    Address Line         |    9414 SW 27TH RD 
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    City                 |    GAINESVILLE
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    State                |    FL
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    Zip                  |    32608-7969
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    Country              |    US
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    Telephone            |    352-514-5464
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9414 SW 27TH RD 
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    City                 |    GAINESVILLE
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    State                |    FL
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    Zip                  |    32608-7969
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    Country              |    US
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    Telephone            |    352-514-5464
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    Fax                  |    
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    MH8063
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    License Number State |    FL
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