Provider Demographics
NPI:1629486857
Name:SLESNICK, JEWEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JEWEL
Middle Name:
Last Name:SLESNICK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 VILLAGE SQUARE XING
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4540
Mailing Address - Country:US
Mailing Address - Phone:267-626-4400
Mailing Address - Fax:
Practice Address - Street 1:800 VILLAGE SQUARE XING
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4540
Practice Address - Country:US
Practice Address - Phone:267-626-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8178103TC0700X
PAPS008446-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical