Provider Demographics
NPI:1225680184
Name:CROFTS, JENNIFER B (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:B
Last Name:CROFTS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:B
Other - Last Name:STOYELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5971 BRICK CT
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-9307
Mailing Address - Country:US
Mailing Address - Phone:407-288-5553
Mailing Address - Fax:
Practice Address - Street 1:5971 BRICK CT
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-9307
Practice Address - Country:US
Practice Address - Phone:407-288-5553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10201103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical