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NPI 1538578463

NPI 1538578463 : JACQUELINE HUEY : JACKSONVILLE, FL

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General NPI Number Information
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    NPI Number           |    1538578463
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    Entity Type          |    Individual 
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    Provider Name        |    JACQUELINE HUEY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/05/2014
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    Last Update Date     |    08/05/2014
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Provider Practice Location Address
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    Address Line         |    6867 SOUTHPOINT DR N STE 106 
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32216-8005
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    Country              |    US
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    Telephone            |    904-619-6071
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4631 RIDGE POINT CT 
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32257-3714
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    Country              |    US
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    Telephone            |    
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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        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    
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    License Number State |    
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