Flood, Jacquelyn Erlene

Flood, Jacquelyn Erlene is an individual health care provider with primary practice located at 262 Crystal Grove Blvd , Lutz FL 33548-6460. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Flood, Jacquelyn Erlene can be contacted via phone (813) 326-5915.

Contact Information

Primary practice address
262 Crystal Grove Blvd Lutz FL 33548-6460
Phone: (813) 326-5915
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY 7586 Florida

Profile Details

NPI number 1548430960
LBN Legal business name Flood, Jacquelyn Erlene
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2008
Last updated Mar 31st, 2021 - about 4 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 1548430960 NPPES
Florida Other 5933D BLUE CROSS BLUE SHIELD
Florida MEDICAID 768739700 BLUE CROSS BLUE SHIELD

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