Provider Demographics
NPI:1912389669
Name:ESCOFFERY, JANET A (PSY D)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:A
Last Name:ESCOFFERY
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14745 NW 174TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-4856
Mailing Address - Country:US
Mailing Address - Phone:386-462-4882
Mailing Address - Fax:
Practice Address - Street 1:14745 NW 174TH AVE
Practice Address - Street 2:
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615-4856
Practice Address - Country:US
Practice Address - Phone:386-462-4882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6371103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist