Provider Demographics
NPI:1265922215
Name:DEVEREAUX, JENNY C
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:C
Last Name:DEVEREAUX
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 1:9100 S DADELAND BLVD SUITE 1500
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156
Mailing Address - Country:US
Mailing Address - Phone:305-929-8705
Mailing Address - Fax:305-600-3713
Practice Address - Street 1:9100 S DADELAND BLVD SUITE 1500
Practice Address - Street 2:SUITE 1500
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156
Practice Address - Country:US
Practice Address - Phone:305-929-8705
Practice Address - Fax:305-600-3713
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool