Provider Information for 1134613474
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JESSICA JANE HERZ LMHC
Sex: Female
NPI: 1134613474
Last Updated: 2018-11-28
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1134613474 | ||||||||
| Enumeration Date | 2018-06-20 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6721 MONTEGO BAY BLVD APT E BOCA RATON, FL 33433-4033 United States Phone: 561-354-6915 | Fax: | ||||||||
| Primary Practice Address | 2623 S SEACREST BLVD STE 118 BOYNTON BEACH, FL 33435-7531 United States Phone: 561-354-6915 | Fax: | ||||||||
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