Provider Demographics
NPI:1114176534
Name:ROBERTS, JENNIFER H (PSYD, MS)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:H
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:PSYD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E. HACKBERRY AVENUE
Mailing Address - Street 2:VA MCALLEN OUTPATIENT CLINIC
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503
Mailing Address - Country:US
Mailing Address - Phone:956-618-7100
Mailing Address - Fax:
Practice Address - Street 1:901 E. HACKBERRY AVENUE
Practice Address - Street 2:VA MCALLEN OUTPATIENT CLINIC
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503
Practice Address - Country:US
Practice Address - Phone:956-618-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28568103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical