Provider Demographics
NPI:1881803781
Name:RUBOLINO, JENNIFER LYN (LMHC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYN
Last Name:RUBOLINO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22684 VISTAWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428
Mailing Address - Country:US
Mailing Address - Phone:954-821-9291
Mailing Address - Fax:866-757-5778
Practice Address - Street 1:205 WORTH AVENUE
Practice Address - Street 2:SUITE 201
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480
Practice Address - Country:US
Practice Address - Phone:954-821-9291
Practice Address - Fax:866-757-5778
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 14608101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health