Provider Demographics
NPI:1437810181
Name:GOSLEY-MCFARLANE, JACQUELINE KAY
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:KAY
Last Name:GOSLEY-MCFARLANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10318 MEADOW CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3182
Mailing Address - Country:US
Mailing Address - Phone:516-458-1524
Mailing Address - Fax:
Practice Address - Street 1:10318 MEADOW CROSSING DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3182
Practice Address - Country:US
Practice Address - Phone:516-458-1524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-05
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW16795104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker