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General NPI Number Information
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NPI Number | 1780642587
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Entity Type | Individual
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Provider Name | PAMELA A JETT MSW/LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 819 S FEDERAL HWY 200B
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City | STUART
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State | FL
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Zip | 34994-2952
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Country | US
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Telephone | 772-219-9566
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 NE M CARI LN
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City | JENSEN BEACH
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State | FL
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Zip | 34957-3743
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Country | US
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Telephone | 772-529-7403
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Fax | 772-334-8104
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW3341
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License Number State | FL
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