MEDICARE: SUE JOBE PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH1750	FL
2	103TS0200X	School Psychologist	SS234	FL

General Provider Information

NPI Number	:	1417364068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUE JOBE PH.D.

Provider Business Mailing Address
First Line	:	717 BISCAYNE DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-7605
Country	:	US
Telephone Number	:	561-255-6001
Fax Number	:

Provider Business Practice Location Address
First Line	:	717 BISCAYNE DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-7605
Country	:	US
Telephone Number	:	561-255-6001
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2014
Last Update Date	:	07/15/2014

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Directions to “ SUE JOBE PH.D.” Practice Location

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