Provider Demographics
NPI:1811139678
Name:CARR, JESSICA ROBERTSON (MA)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ROBERTSON
Last Name:CARR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9220 BONITA BEACH RD SE STE 200
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-4231
Mailing Address - Country:US
Mailing Address - Phone:239-895-8146
Mailing Address - Fax:239-201-2034
Practice Address - Street 1:9220 BONITA BEACH RD SE STE 200
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4231
Practice Address - Country:US
Practice Address - Phone:239-895-8146
Practice Address - Fax:239-201-2034
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-25
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health