Dreggors, Jesse Wayne

Dreggors, Jesse Wayne is an individual health care provider with primary practice located at 237 Fernwood Blvd , Fern Park FL 32730-2116. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Dreggors, Jesse Wayne can be contacted via phone (407) 323-2036.

Contact Information

Primary practice address
237 Fernwood Blvd Fern Park FL 32730-2116
Phone: (407) 323-2036
Fax: (407) 831-0195
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X MH 664 Florida
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH0664 Florida

Profile Details

NPI number 1407041262
LBN Legal business name Dreggors, Jesse Wayne
Credentials LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2007
Last updated Nov 18th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407041262 NPPES
Florida MEDICAID 768236100
Florida MEDICAID 768515700

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