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NPI Code Detail

MEDICARE: DR. JANET ALLISON ANGUAS-KEITER PSY.D.

MEDICARE: DR. JANET ALLISON ANGUAS-KEITER PSY.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
1103TC0700XClinical Psychologist8069FL

General Provider Information

NPI Number : 1467775379
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JANET ALLISON ANGUAS-KEITER PSY.D.
Provider Business Mailing Address
First Line : 165 WELLS RD STE 303
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-3036
Country : US
Telephone Number : 904-264-8311
Fax Number :
Provider Business Practice Location Address
First Line : 165 WELLS RD STE 303
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-3036
Country : US
Telephone Number : 904-264-8311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2010
Last Update Date : 03/05/2010

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