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General NPI Number Information
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NPI Number | 1851500946
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Entity Type | Individual
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Provider Name | JEANETTA GRIFFITH TEPPER LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 09/25/2008
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Provider Practice Location Address
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Address Line | 1750 SW HEALTH PKWY
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City | NAPLES
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State | FL
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Zip | 34109-0420
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Country | US
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Telephone | 239-405-1314
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Fax | 239-566-7355
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Provider Business Mailing Address
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Address Line | 26420 LUCKY STONE ROAD UNIT #102
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City | BONITA SPRINGS
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State | FL
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Zip | 34135
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Country | US
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Telephone | 239-405-1314
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Fax | 239-594-8762
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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 | SW7646
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34000373A
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License Number State | IN
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