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General NPI Number Information
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NPI Number | 1871631994
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Entity Type | Individual
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Provider Name | JERI HOSICK PH.D, LMHC
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Gender | Female
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1402 ROYAL PALM BEACH BLVD
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-1691
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Country | US
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Telephone | 561-792-7755
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Fax | 561-792-0399
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Provider Business Mailing Address
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Address Line | 320 SANDPIPER AVE
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-2941
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Country | US
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Telephone | 561-795-6296
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Fax | 561-792-0399
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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 | MH 2784
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License Number State | FL
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