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General NPI Number Information
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NPI Number | 1629469200
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Entity Type | Individual
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Provider Name | JENNIFER ANN PUPARD LICENSED PSYCHOLOGIS
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Gender | Female
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Dates
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Enumeration Date | 02/18/2015
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Last Update Date | 11/22/2017
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Provider Practice Location Address
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Address Line | 3279 CLINT MOORE RD APT 206
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City | BOCA RATON
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State | FL
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Zip | 33496-3932
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Country | US
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Telephone | 989-501-1796
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Fax |
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Provider Business Mailing Address
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Address Line | 3279 CLINT MOORE RD APT 206
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City | BOCA RATON
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State | FL
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Zip | 33496-3932
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Country | US
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Telephone | 989-501-1796
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | SS1215
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY 9467
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License Number State | FL
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