Provider Demographics
NPI:1609201284
Name:MCLOSKY, JENNIFER LYNN (MS CGC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:MCLOSKY
Suffix:
Gender:F
Credentials:MS CGC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:FICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:360 CENTRAL AVE
Mailing Address - Street 2:SUITE 1230
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3857
Mailing Address - Country:US
Mailing Address - Phone:760-778-4434
Mailing Address - Fax:760-203-1191
Practice Address - Street 1:360 CENTRAL AVE
Practice Address - Street 2:SUITE 1230
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3857
Practice Address - Country:US
Practice Address - Phone:760-778-4434
Practice Address - Fax:760-203-1191
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS