Provider Demographics
NPI:1164596086
Name:PEEL, JEANNE M (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:M
Last Name:PEEL
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WHISPERING CIR
Mailing Address - Street 2:APT #15
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-0899
Mailing Address - Country:US
Mailing Address - Phone:904-824-8734
Mailing Address - Fax:
Practice Address - Street 1:1110 EDGEWOOD AVE W
Practice Address - Street 2:CHILD GUIDANCE CENTER, INC
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-6405
Practice Address - Country:US
Practice Address - Phone:904-924-1550
Practice Address - Fax:904-924-1544
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2186106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist