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General NPI Number Information
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NPI Number | 1992285936
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Entity Type | Organization
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Legal Business Name | JENNIFER RICHARDSON PSYD, PA
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Dates
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Enumeration Date | 08/20/2018
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 20747 STERLINGTON DR
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City | LAND O LAKES
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State | FL
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Zip | 34638-4317
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Country | US
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Telephone | 813-907-9191
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Fax | 813-948-0094
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Provider Business Mailing Address
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Address Line | 20747 STERLINGTON DR
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City | LAND O LAKES
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State | FL
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Zip | 34638-4317
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Country | US
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Telephone | 727-688-5756
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Fax | 813-948-0094
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER ANNE RICHARDSON
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Credential | PSYD
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Telephone | 727-688-5756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY10020
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License Number State | FL
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