Provider Demographics
NPI:1043691140
Name:DOCKERY, JANET (EDD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:DOCKERY
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:DOCKERY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:EDD
Mailing Address - Street 1:6030 46TH LN
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32967-6166
Mailing Address - Country:US
Mailing Address - Phone:719-251-4958
Mailing Address - Fax:
Practice Address - Street 1:6030 46TH LN
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32967-6166
Practice Address - Country:US
Practice Address - Phone:719-251-4958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor