Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | PY8369 | FL |
NPI | 1104107937 |
---|---|
Provider Name | Dr. Jessica Barrett Kordansky |
First Address | Boca Raton, FL 33432-3845 |
Second Address | Boca Raton, FL 33432-3845 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2011 |
Last Update Date | 27/02/2014 |