Provider Demographics
NPI:1629365143
Name:CORTEZ, JAYNE A (SOCIAL WORKER)
Entity Type:Individual
Prefix:MRS
First Name:JAYNE
Middle Name:A
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N 2ND ST
Mailing Address - Street 2:STE. 301
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4435
Mailing Address - Country:US
Mailing Address - Phone:772-575-3773
Mailing Address - Fax:
Practice Address - Street 1:121 N 2ND ST
Practice Address - Street 2:STE. 301
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4435
Practice Address - Country:US
Practice Address - Phone:772-575-3773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker