Provider Demographics
NPI:1033872163
Name:JEANLOZ THERAPY LLC
Entity Type:Organization
Organization Name:JEANLOZ THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:JEANLOZ
Authorized Official - Suffix:
Authorized Official - Credentials:MSSW
Authorized Official - Phone:941-451-7568
Mailing Address - Street 1:12700 N BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-9003
Mailing Address - Country:US
Mailing Address - Phone:941-371-3901
Mailing Address - Fax:
Practice Address - Street 1:12700 N BRANCH RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-9003
Practice Address - Country:US
Practice Address - Phone:941-451-7568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty